Sample records for upper temporal quadrant

  1. Changes in retinal microvascular diameter in patients with diabetes

    PubMed Central

    da Silva, Andréa Vasconcellos Batista; Gouvea, Sonia Alves; da Silva, Aurélio Paulo Batista; Bortolon, Saulo; Rodrigues, Anabel Nunes; Abreu, Glaucia Rodrigues; Herkenhoff, Fernando Luiz

    2015-01-01

    Background and objectives Diabetic retinopathy is the main microvascular complication in diabetes mellitus and needs to be diagnosed early to prevent severe sight-threatening retinopathy. The purpose of this study was to quantify the retinal microvasculature pattern and analyze the influence of blood glucose level and the duration of diabetes mellitus on the retinal microvasculature. Methods Two groups were analyzed: patients with diabetes (N=26) and patients without diabetes, ie, controls (N=26). A quantitative semiautomated method analyzed retinal microvasculature. The diameters of arterioles and venules were measured. The total numbers of arterioles and venules were counted. The ratio of arteriole diameter to venule diameter was calculated. The retinal microvasculature pattern was related to clinical and biochemical parameters. Results Patients with diabetes exhibited larger venule diameters in the upper temporal quadrant of the retina compared to the lower temporal quadrant (124.85±38.03 µm vs 102.92±15.69 µm; P<0.01). Patients with diabetes for 5 or more years had larger venule diameters in the upper temporal quadrant than patients without diabetes (141.62±44.44 vs 112.58±32.11 µm; P<0.05). The degree of venodilation in the upper temporal quadrant was positively correlated with blood glucose level and the estimated duration of diabetes mellitus. Interpretation and conclusion The employed quantitative method demonstrated that patients with diabetes exhibited venule dilation in the upper temporal quadrant, and the duration of diabetes mellitus was positively correlated with blood glucose level. Therefore, the early assessment of retinal microvascular changes is possible prior to the onset of diabetic retinopathy. PMID:26345217

  2. Clinical presentation and manual therapy for upper quadrant musculoskeletal conditions

    PubMed Central

    Isabel de-la-Llave-Rincón, Ana; Puentedura, Emilio J; Fernández-de-las-Peñas, César

    2011-01-01

    In recent years, increased knowledge of the pathogenesis of upper quadrant pain syndromes has translated to better management strategies. Recent studies have demonstrated evidence of peripheral and central sensitization mechanisms in different local pain syndromes of the upper quadrant such as idiopathic neck pain, lateral epicondylalgia, whiplash-associated disorders, shoulder impingement, and carpal tunnel syndrome. Therefore, a treatment-based classification approach where subjects receive matched interventions has been developed and, it has been found that these patients experience better outcomes than those receiving non-matched interventions. There is evidence suggesting that the cervical and thoracic spine is involved in upper quadrant pain. Spinal manipulation has been found to be effective for patients with elbow pain, neck pain, or cervicobrachial pain. Additionally, it is known that spinal manipulative therapy exerts neurophysiological effects that can activate pain modulation mechanisms. This paper exposes some manual therapies for upper quadrant pain syndromes, based on a nociceptive pain rationale for modulating central nervous system including trigger point therapy, dry needling, mobilization or manipulation, and cognitive pain approaches. PMID:23115473

  3. Chlamydia trachomatis-induced Fitz-Hugh-Curtis syndrome: a case report.

    PubMed

    Ekabe, Cyril Jabea; Kehbila, Jules; Njim, Tsi; Kadia, Benjamin Momo; Tendonge, Celestine Ntemlefack; Monekosso, Gottlieb Lobe

    2017-01-03

    Fitz-Hugh-Curtis syndrome is defined as perihepatitis associated with pelvic inflammatory disease. Chlamydia trachomatis is one of its most common aetiologies. This syndrome usually presents with right upper quadrant abdominal pain mimicking other hepatobiliary and gastrointestinal pathologies, hence, posing a diagnostic dilemma in settings with limited diagnostic tools. A 32 year old African female presented with acute right upper quadrant abdominal pain and vaginal discharge, for which she had previously received treatment in another health center with no improvement. Clinical and laboratory findings were suggestive of Fitz-Hugh-Curtis syndrome. Five days after treatment with oral doxycycline, the patient showed marked clinical improvement. Fitz-Hugh-Curtis syndrome is a common cause of right upper quadrant pain which is often under diagnosed in poor communities. Hence, it should be included as a differential diagnosis in patients presenting with right upper quadrant pain, especially in females of reproductive age.

  4. Evaluation of the association between quantitative mammographic density and breast cancer occurred in different quadrants.

    PubMed

    Chan, Siwa; Chen, Jeon-Hor; Li, Shunshan; Chang, Rita; Yeh, Darh-Cherng; Chang, Ruey-Feng; Yeh, Lee-Ren; Kwong, Jessica; Su, Min-Ying

    2017-04-17

    To investigate the relationship between mammographic density measured in four quadrants of a breast with the location of the occurred cancer. One hundred and ten women diagnosed with unilateral breast cancer that could be determined in one specific breast quadrant were retrospectively studied. Women with previous cancer/breast surgery were excluded. The craniocaudal (CC) and mediolateral oblique (MLO) mammography of the contralateral normal breast were used to separate a breast into 4 quadrants: Upper-Outer (UO), Upper-Inner (UI), Lower-Outer (LO), and Lower-Inner (LI). The breast area (BA), dense area (DA), and percent density (PD) in each quadrant were measured by using the fuzzy-C-means segmentation. The BA, DA, and PD were compared between patients who had cancer occurring in different quadrants. The upper-outer quadrant had the highest BA (37 ± 15 cm 2 ) and DA (7.1 ± 2.9 cm 2 ), with PD = 20.0 ± 5.8%. The order of BA and DA in the 4 separated quadrants were: UO > UI > LO > LI, and almost all pair-wise comparisons showed significant differences. For tumor location, 67 women (60.9%) had tumor in UO, 16 (14.5%) in UI, 7 (6.4%) in LO, and 20 (18.2%) in LI quadrant, respectively. The estimated odds and the 95% confidence limits of tumor development in the UO, UI, LO and LI quadrants were 1.56 (1.06, 2.29), 0.17 (0.10, 0.29), 0.07 (0.03, 0.15), and 0.22 (0.14, 0.36), respectively. In these 4 groups of women, the order of quadrant BA and DA were all the same (UO > UI > LO > LI), and there was no significant difference in BA, DA or PD among them (all p > 0.05). Breast cancer was most likely to occur in the UO quadrant, which was also the quadrant with highest BA and DA; but for women with tumors in other quadrants, the density in that quadrant was not the highest. Therefore, there was no direct association between quadrant density and tumor occurrence.

  5. A systematic review of posture and psychosocial factors as contributors to upper quadrant musculoskeletal pain in children and adolescents.

    PubMed

    Prins, Yolandi; Crous, Lynette; Louw, Q A

    2008-01-01

    Musculoskeletal pain has become a major symptomatic complaint among children and adolescents and is increasingly occurring at a younger age. This systematic review was done to evaluate the evidence for the contribution of posture and psychosocial factors to the development of upper quadrant musculoskeletal pain in children and adolescents. The review describes the measurement tools used to assess musculoskeletal pain, sitting posture, and psychosocial factors. Two independent reviewers searched seven databases for observational studies that included prospective and cross-sectional study designs. Ten studies were extracted and assessed by two reviewers using the Critical Appraisal Form-Quantitative Studies (Law et al, 1998). The studies measured upper quadrant musculoskeletal pain as an outcome measure. Five studies evaluated sitting posture and found an association between the duration of static sitting and upper quadrant musculoskeletal pain. Six studies measured psychosocial factors of which depression, stress, and psychosomatic symptoms were the factors most commonly found to influence the development of upper quadrant musculoskeletal pain. The eligible studies used different pain measurement tools and different measurement tools to assess sitting posture and psychosocial factors. This review concludes that the duration of sitting posture and psychosocial factors may influence the experience of musculoskeletal pain among children and adolescents.

  6. Natural history of Leber's hereditary optic neuropathy: longitudinal analysis of the retinal nerve fiber layer by optical coherence tomography.

    PubMed

    Barboni, Piero; Carbonelli, Michele; Savini, Giacomo; Ramos, Carolina do V F; Carta, Arturo; Berezovsky, Adriana; Salomao, Solange R; Carelli, Valerio; Sadun, Alfredo A

    2010-03-01

    To investigate by optical coherence tomography (OCT) the topographic pattern and temporal sequence of fiber loss in the peripapillary retinal nerve fiber layer (RNFL) of patients with Leber's hereditary optic neuropathy (LHON) in a longitudinal follow-up. Cohort study. Six eyes of 4 patients with molecularly defined LHON were enrolled before the subacute period of visual loss. Subjects were studied by StratusOCT (Carl Zeiss Meditec, Inc., Dublin, CA) during a 9-month follow-up starting from the presymptomatic stage of the disease. Examinations were carried out at 4 different time points: presymptomatic stage, time of visual loss, and 3 and 9 months later. Peripapillary RNFL thickness for each quadrant of the optic nerve. Statistical comparisons were performed by ordinary analysis of variance with Dunnett's post-test. A significant increase of RNFL thickness was detected in the temporal and inferior quadrants between the presymptomatic stage and the disease onset (P<0.05). The 360-degree average and the superior and nasal quadrants showed a nonstatistically significant increase of thickness at this time. In the 360-degree average (P<0.01), superior (P<0.01), nasal (P<0.05), and inferior (P<0.01) quadrants, RNFL thickening showed statistically significant changes between the presymptomatic stage and the 3-month follow-up. At 3 months, a nonsignificant reduction of RNFL thickness was detected in the temporal quadrant. A significant reduction of RNFL was detected in all but the nasal quadrants between the presymptomatic stage and the 9-month Follow-up. The RNFL thickness increase first appeared at the temporal and inferior quadrants. Conversely, at 3 months the thickening fibers were more evident in the superior and nasal quadrants. These findings are consistent with the established preferential early involvement of the papillomacular bundle in LHON. We also demonstrated the previously unrecognized simultaneous early involvement of the inferior quadrant. The late involvement of both superior and nasal quadrants suggests a dynamic evolution of the acute stage that continues for 3 months and may represent a therapeutic window of opportunity. Copyright 2010 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  7. Survey of Nerve Fiber Layer Thickness in Anisometropic and Strabismic Amblyopia.

    PubMed

    Soltani Moghaddam, Reza; Medghalchi, Abdolreza; Alizadeh, Yousef

    2017-01-01

    . To investigate the effect of anisometropic and strabismic amblyopia on the nerve fiber layer thickness. This cross-sectional study was done on 54 amblyopic subjects, equally in both strabismic and anisometropic groups. The thickness otonerve fiber layer measured in superior, inferior, nasal, temporal quadrants and as a whole in both eyes of both groups. The means of thickness were compared in amblyopic and sound eyes. In strabismus group, the average nerve fiber layer thickness of the sound eye , in superior, inferior, nasal and temporal quadrants and as a whole were 113.23±14, 117.37±25, 68.96±6, 69.55±14 and 93.40±8 microns respectively. In amblyopic eyes of the same group, these measurements were 103.11±18, 67.74±11, and 69.59±16 and 89.59±12 microns in superior, inferior, nasal, temporal quadrants and as whole respectively. In anisometropic groups, the sound eye measurements were as 130.96±22, 129.07±29, 80.62±12, and 83.88±20 and 107.7±13 microns in superior, inferior, nasal and temporal quadrants and as a whole orderly. In amblyopic eyes of this group the mean thicknesses were 115.63±29, 133.15±25, 78.8±15, 80.2±16 and 109.17±21 microns in superior, inferior, nasal, temporal quadrants and as a whole respectively. Statistically, there were no significant differences between amblyopic and sound eyes (P>0.5). Our study did not support any significant change in a nerve fiber layer thickness of amblyopic patients; however, decreased thickness in superior and nasal quadrants of strabismic amblyopia and except inferior quadrant and as a whole. These measurements may be a clue for management and prognosis of amblyopia in old age.

  8. Diagnosis of Upper-Quadrant Lymphedema Secondary to Cancer: Clinical Practice Guideline From the Oncology Section of APTA

    PubMed Central

    Levenhagen, Kimberly; Davies, Claire; Perdomo, Marisa; Ryans, Kathryn

    2017-01-01

    Introduction: The Oncology Section of APTA developed a clinical practice guideline to aid the clinician in diagnosing secondary upper-quadrant cancer-related lymphedema. Methods: Following a systematic review of published studies and a structured appraisal process, recommendations were written to guide the physical therapist and other health care clinicians in their diagnostic process. Overall, clinical practice recommendations were formulated on the basis of the evidence for each diagnostic method and were assigned a grade based on the strength of the evidence for different patient presentations and clinical utility. Recommendations: In an effort to make these clinically applicable, recommendations were based on the characteristics as to the location and stage of a patient's upper-quadrant lymphedema. PMID:28748128

  9. An efficient indexing scheme for binary feature based biometric database

    NASA Astrophysics Data System (ADS)

    Gupta, P.; Sana, A.; Mehrotra, H.; Hwang, C. Jinshong

    2007-04-01

    The paper proposes an efficient indexing scheme for binary feature template using B+ tree. In this scheme the input image is decomposed into approximation, vertical, horizontal and diagonal coefficients using the discrete wavelet transform. The binarized approximation coefficient at second level is divided into four quadrants of equal size and Hamming distance (HD) for each quadrant with respect to sample template of all ones is measured. This HD value of each quadrant is used to generate upper and lower range values which are inserted into B+ tree. The nodes of tree at first level contain the lower and upper range values generated from HD of first quadrant. Similarly, lower and upper range values for the three quadrants are stored in the second, third and fourth level respectively. Finally leaf node contains the set of identifiers. At the time of identification, the test image is used to generate HD for four quadrants. Then the B+ tree is traversed based on the value of HD at every node and terminates to leaf nodes with set of identifiers. The feature vector for each identifier is retrieved from the particular bin of secondary memory and matched with test feature template to get top matches. The proposed scheme is implemented on ear biometric database collected at IIT Kanpur. The system is giving an overall accuracy of 95.8% at penetration rate of 34%.

  10. Oncoplastic Surgery for Upper/Upper Inner Quadrant Breast Cancer.

    PubMed

    Lin, Joseph; Chen, Dar-Ren; Wang, Yu-Fen; Lai, Hung-Wen

    2016-01-01

    Tumors located in the upper/upper inner quadrant of the breast warrant more attention. A small lesion relative to the size of breast in this location may be resolved by performing a level I oncoplastic technique. However, a wide excision may significantly reduce the overall quality of the breast shape by distorting the visible breast line. From June 2012 to April 2015, 36 patients with breast cancer located in the upper/upper inner quadrant underwent breast-conservation surgery with matrix rotation mammoplasty. According to the size and location of the tumor relative to the nipple-areola complex, 11 patients underwent matrix rotation with periareolar de-epithelialization (donut group) and the other 25 underwent matrix rotation only (non-donut group). The cosmetic results were self-assessed by questionnaires. The average weights of the excised breast lumps in the donut and non-donut groups were 104.1 and 84.5 g, respectively. During the 3-year follow-up period, local recurrence was observed in one case and was managed with nipple-sparing mastectomy followed by breast reconstruction with prosthetic implants. In total, 31 patients (88.6%) ranked their postoperative result as either acceptable or satisfactory. The treated breasts were also self-evaluated by 27 patients (77.1%) to be nearly identical to or just slightly different from the untreated side. Matrix rotation is an easy breast-preserving technique for treating breast cancer located in the upper/upper inner quadrant of the breast that requires a relatively wide excision. With this technique, a larger breast tumor could be removed without compromising the breast appearance.

  11. Establishing Law and Order After Conflict

    DTIC Science & Technology

    2005-01-01

    the y-axis indicates the rule of law. This leads to four quadrants . We code the lower-left quadrant as successful, since it includes decreasing...levels of violence and an improving rule of law. The lower-right quadrant is mixed because it includes increasing levels of violence but an improving rule...of law. Cases in the upper-right quadrant are un- successful, since they have increasing levels of violence and a deterio- rating rule of law

  12. Diagnosis of Upper Quadrant Lymphedema Secondary to Cancer: Clinical Practice Guideline From the Oncology Section of the American Physical Therapy Association

    PubMed Central

    Levenhagen, Kimberly; Davies, Claire; Perdomo, Marisa; Ryans, Kathryn

    2017-01-01

    Abstract The Oncology Section of the American Physical Therapy Association (APTA) developed a clinical practice guideline to aid the clinician in diagnosing secondary upper quadrant cancer-related lymphedema. Following a systematic review of published studies and a structured appraisal process, recommendations were written to guide the physical therapist and other health care clinicians in the diagnostic process. Overall clinical practice recommendations were formulated based on the evidence for each diagnostic method and were assigned a grade based on the strength of the evidence for different patient presentations and clinical utility. In an effort to maximize clinical applicability, recommendations were based on the characteristics as to the location and stage of a patient's upper quadrant lymphedema. PMID:28838217

  13. [Clinical significance of four quadrant localization in the diagnosis and treatment of metastatic carcinoma of the neck with unknown primary].

    PubMed

    Gao, Y Y; Chen, X H

    2017-06-05

    Objective: The aim of this study is to investigate the clinical significance of four quadrant localization in the diagnosis and treatment of unknown primary cervical metastases. Method: The clinical data with unknown primary cervical metastases, were analyzed retrospectively. All the patients have not been found the original site in the initial treatment. There are four quadrants in the neck, the neck line as the longitudinal axis, and edge of cricoid cartilage as the horizontal axis. When cervical metastasis occurred in the left and right upper quadrant, the primary tumor site and radiotherapy from the skull base to the root of the neck; when appear in left and right lower quadrant, the primary investigation site and radiotherapy from neck to thoracic mediastinum, left lower abdomen also includes following primary search. At the same time, bilateral cervical metastasis cancers, focusing on the central line near the primary focus. Specific treatment strategies include ipsilateral total neck dissection and radical radiotherapy of the above radiotherapy site. Result: Left upper neck in 4 cases, right upper neck in 5 cases, left lower neck in 7 cases, lower right neck in 8 cases and mixed area in 6 cases. Only 10 of 30 patients (33.3%) with primary sites were found in the follow up period. In accordance with the four quadrant localization, the median time was 6 months. Conclusion: Four quadrant localization to locate the primary site is accurate, and individualized comprehensive treatment is the key to improve the curative effect. Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.

  14. The impact of previous para-areolar incision in the upper outer quadrant of the breast on the localization of the sentinel lymph node in a canine model

    PubMed Central

    Vasques, Paulo Henrique Diógenes; Pinheiro, Luiz Gonzaga Porto; de Meneses e Silva, João Marcos; de Moura Torres-de-Melo, José Ricardo; Pinheiro, Karine Bessa Porto; Rocha, João Ivo Xavier

    2011-01-01

    OBJECTIVES: This paper discusses the influence of a para-areolar incision in the upper outer quadrant of the breast on the location of the sentinel lymph node in a canine model. METHODS: The sentinel lymph node was marked with technetium-99, which was injected into the subareolar skin of the cranial breast. After the marker had migrated to the axilla, an arcuate para-areolar incision was performed 2 cm from the nipple in the upper outer quadrant. Patent blue dye was then injected above the upper border of the incision. At the marked site, an axillary incision was made, and the sentinel lymph node was identified by gamma probe and/or by direct visualization of the dye. The agreement between the two injection sites and the two sentinel lymph node identification methods was determined. Our sample group consisted of 40 cranial breasts of 23 adult females of the species Canis familiaris. The data were analyzed by using the McNemar test and by determining the kappa agreement coefficient. RESULT: Our findings showed that in 95% of the breasts, the sentinel lymph node was identified by the injection of technetium-99 m into the subareolar region, and in 82% of the cases, the sentinel lymph node was identified by the injection of patent blue dye above the upper border of the incision. The methods agreed 82% of the time. CONCLUSIONS: Previous para-areolar incisions in the upper outer quadrant did not interfere significantly with the biopsy when the dye was injected above the upper border of the incision. PMID:21915493

  15. Neural Network Analysis of Different Segmentation Strategies of Nerve Fiber Layer Assessment for Glaucoma Diagnosis.

    PubMed

    Larrosa, Jose M; Polo, Vicente; Ferreras, Antonio; García-Martín, Elena; Calvo, Pilar; Pablo, Luis E

    2015-12-01

    To compare the diagnostic performance of different segmentations of the nerve fiber layer (NFL) thickness measurements using an artificial neural network and to define the optimal number of sectors with best diagnostic ability for glaucoma diagnosis. A total of 117 glaucoma patients and 123 normal subjects were included in the study. NFL thickness measurements were performed using the Spectralis-OCT (Heidelberg Engineering) to obtain the NFL thickness average; measurements from 2 semicircles, 4 quadrants, and 6, 8, 12, 16, 24, 32, and 64 sectors; and 768 uniformly divided locations around the peripapillary NFL. An artificial neural network evaluation was performed to compare the influence of sector analysis on the diagnostic performance of optical coherence tomography. Receiver operating characteristic curves were used to compare the diagnostic ability of the different segmentation analyses. The 6 sectors divided by the horizontal division of the nasal and temporal quadrants were better than the 6 sectors divided by the vertical line through the superior and inferior quadrants [areas under curve, 0.778; 95% confidence interval (CI), 0.720-0.829 and 0.814; 95% CI, 0.759-0.861, respectively]. In the case of quadrants, clock quadrants (area under curve 0.770; 95% CI, 0.712-0.822) were better than the ISNT (inferior-superior-nasal-temporal) quadrants (area under curve, 0.770; 95% CI, 0.712-0.822; P=0.003). The first segmentation strategy that improved the diagnostic value of 4 ISNT quadrants was the 12-sector analysis (area under curve, 0.845; 95% CI, 0.793-0.889; P=0.001). The 2 best candidate strategies for the OCT report were the 12-sector analysis and the 4 planimetric quadrant (alternatively, the 4 clock quadrants) analysis.

  16. Comparison of Scheimpflug imaging and spectral domain anterior segment optical coherence tomography for detection of narrow anterior chamber angles.

    PubMed

    Grewal, D S; Brar, G S; Jain, R; Grewal, S P S

    2011-05-01

    To compare the performance of anterior chamber volume (ACV) and anterior chamber depth (ACD) obtained using Scheimpflug imaging with angle opening distance (AOD500) and trabecular-iris space area (TISA500) obtained using spectral domain anterior segment optical coherence tomography (SD-ASOCT) in detecting narrow angles classified using gonioscopy. In this prospective, cross-sectional observational study, 265 eyes of 265 consecutive patients underwent sequential Scheimpflug imaging, SD-ASOCT imaging, and gonioscopy. Correlations between gonioscopy grading, ACV, ACD, AOD500, and TISA500 were evaluated. Area under receiver operating characteristic curve (AUC), sensitivity, specificity, and likelihood ratios (LRs) were calculated to assess the performance of ACV, ACD, AOD500, and TISA500 in detecting narrow angles (defined as Shaffer grade ≤1 in all quadrants). SD-ASOCT images were obtained at the nasal and temporal quadrants only. Twenty-eight eyes (10.6%) were classified as narrow angles on gonioscopy. ACV correlated with gonioscopy grading (P<0.001) for temporal (r=0.204), superior (r=0.251), nasal (r=0.213), and inferior (r=0.236) quadrants. ACV correlated with TISA500 for nasal (r=0.135, P=0.029) and temporal (P=0.160, P=0.009) quadrants and also with AOD500 for nasal (r=0.498, P<0.001) and temporal (r=0.517, P<0.001) quadrants. For detection of narrow angles, ACV (AUC=0.935; 95% confidence interval (CI) =0.898-0.961) performed similar to ACD (AUC=0.88, P=0.06) and significantly better than AOD500 nasal (AUC=0.761, P=0.001), AOD500 temporal (AUC=0.808, P<0.001), TISA500 nasal (AUC=0.756, P<0.001), and TISA500 temporal (AUC=0.738, P<0.001). Using a cutoff of 113 mm(3), ACV had 90% sensitivity and 88% specificity for detecting narrow angles. Positive and negative LRs for ACV were 8.63 (95% CI=7.4-10.0) and 0.11 (95% CI=0.03-0.4), respectively. ACV measurements using Scheimpflug imaging outperformed AOD500 and TISA500 using SD-ASOCT for detecting narrow angles.

  17. Right Upper Quadrant Pain: Ultrasound First!

    PubMed

    Revzin, Margarita V; Scoutt, Leslie M; Garner, Joseph G; Moore, Christopher L

    2017-10-01

    Acute right upper quadrant (RUQ) pain is a common presenting symptom in emergency departments and outpatient medical practices, and is most commonly attributable to biliary and hepatic pathology. Ultrasound should be used as a first-line imaging modality for the diagnosis of gallstones and cholecystitis, as it allows the differentiation of medical and surgical causes of upper abdominal pathology, and in many circumstances is sufficient to guide patient management. Knowledge of strengths and limitations of ultrasound in the evaluation of RUQ is paramount in correct diagnosis. A spectrum of RUQ pathology for which a RUQ ultrasound examination should reasonably be considered as the initial imaging modality of choice will be reviewed. © 2017 by the American Institute of Ultrasound in Medicine.

  18. Anisotropies in the perceived spatial displacement of motion-defined contours: opposite biases in the upper-left and lower-right visual quadrants.

    PubMed

    Fan, Zhao; Harris, John

    2010-10-12

    In a recent study (Fan, Z., & Harris, J. (2008). Perceived spatial displacement of motion-defined contours in peripheral vision. Vision Research, 48(28), 2793-2804), we demonstrated that virtual contours defined by two regions of dots moving in opposite directions were displaced perceptually in the direction of motion of the dots in the more eccentric region when the contours were viewed in the right visual field. Here, we show that the magnitude and/or direction of these displacements varies in different quadrants of the visual field. When contours were presented in the lower visual field, the direction of perceived contour displacement was consistent with that when both contours were presented in the right visual field. However, this illusory motion-induced spatial displacement disappeared when both contours were presented in the upper visual field. Also, perceived contour displacement in the direction of the more eccentric dots was larger in the right than in the left visual field, perhaps because of a hemispheric asymmetry in attentional allocation. Quadrant-based analyses suggest that the pattern of results arises from opposite directions of perceived contour displacement in the upper-left and lower-right visual quadrants, which depend on the relative strengths of two effects: a greater sensitivity to centripetal motion, and an asymmetry in the allocation of spatial attention. Copyright © 2010 Elsevier Ltd. All rights reserved.

  19. Evaluation of retinal nerve fiber layer thickness and choroidal thickness in pseudoexfoliative glaucoma and pseudoexfoliative syndrome.

    PubMed

    Ozge, Gokhan; Koylu, Mehmet Talay; Mumcuoglu, Tarkan; Gundogan, Fatih Cakir; Ozgonul, Cem; Ayyildiz, Onder; Kucukevcilioglu, Murat

    2016-05-01

    To compare retinal nerve fiber layer thickness (RNFLT) and choroidal thickness (ChT) measurements in eyes with pseudoexfoliative (PEX) glaucoma, PEX syndrome and healthy control eyes. Eighteen patients with PEX glaucoma in one eye and PEX syndrome in the fellow eye were included. The right eyes of thirty-nine age- and sex-matched healthy subjects were included as control group. All participants underwent a detailed biomicroscopic and funduscopic examination. RNFLT and ChT measurements were performed with a commercially available spectral-domain optical coherence tomography (SD-OCT). ChT measurements were performed by using enhanced depth imaging (EDI) mode. Patients with PEX underwent diurnal IOP measurements with 4-hour intervals before inclusion in the study. RNFLT results included the average measurement and 6 quadrants (temporal, inferotemporal, inferonasal, nasal, superonasal and supero-temporal). ChT measurements were performed in the subfoveal region and around the fovea (500µm and 1500 µm nasal and temporal to the fovea), as well as around the optic disc (average peripapillary and eight quadrants in the peripapillary region (temporal, inferotemporal, inferior, inferonasal, nasal, superonasal, superior, supero-temporal)). RNFLT in all quadrants and average thickness were significantly lower in PEX glaucoma eyes compared to PEX syndrome eyes and healthy control eyes (p<0.001 for both). RNFLT comparisons between PEX syndrome and healthy control eyes did not show a significant difference (p>0.05) except the inferotemporal quadrant. ChT measurements were similar between groups (p>0.05). Thinning of the RNFL in association with unchanged ChT may mean that the presence of PEX material is a much more significant risk factor than choroidal changes in the progression of PEX syndrome to PEX glaucoma.

  20. Poor Prognosis of Lower Inner Quadrant in Lymph Node-negative Breast Cancer Patients Who Received No Chemotherapy: A Study Based on Nationwide Korean Breast Cancer Registry Database.

    PubMed

    Hwang, Ki-Tae; Kim, Jongjin; Kim, Eun-Kyu; Jung, Sung Hoo; Sohn, Guiyun; Kim, Seung Il; Jeong, Joon; Lee, Hyouk Jin; Park, Jin Hyun; Oh, Sohee

    2017-07-01

    We aimed to investigate the prognostic influence of primary tumor site on the survival of patients with breast cancer. Data of 63,388 patients with primary breast cancer from the Korean Breast Cancer Registry were analyzed. Primary tumor sites were classified into 5 groups: upper outer quadrant, lower outer quadrant, upper inner quadrant, lower inner quadrant (LIQ), and central portion. We analyzed overall survival (OS) and breast cancer-specific survival (BCSS) according to primary tumor site. Central portion and LIQ showed lower survival rates regarding both OS and BCSS compared with the other 3 quadrants (all P < .05) and hazard ratios were 1.267 (95% CI, 1.180-1.360, P < .001) and 1.215 (95% CI, 1.097-1.345, P < .001), respectively. Although central portion showed more unfavorable clinicopathologic features, LIQ showed more favorable features than the other 3 quadrants. Primary tumor site was a significant factor in univariate and multivariate analyses for OS and BCSS (all P < .001). For lymph node-negative patients, LIQ showed a worse OS than the other primary tumor sites in the subgroup with no chemotherapy (P < .001), but that effect disappeared in the subgroup with chemotherapy (P = .058). LIQ showed a worse prognosis despite having more favorable clinicopathologic features than other tumor locations and it was more prominent for lymph node-negative patients who received no chemotherapy. The hypothesis of possible hidden internal mammary node metastasis could be suggested to play a key role in LIQ lesions. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Orbital dermoid and epidermoid cysts: case study.

    PubMed

    Veselinović, Dragan; Krasić, Dragan; Stefanović, Ivan; Veselinović, Aleksandar; Radovanović, Zoran; Kostić, Aleksandar; Cvetanović, Marija

    2010-01-01

    Dermoid and epidermoid cysts of the orbit belong to choristomas, tumours that originate from the aberrant primordial tissue. Clinically, they manifest as cystic movable formations mostly localized in the upper temporal quadrant of the orbit. They are described as both superficial and deep formations with most frequently slow intermittent growth. Apart from aesthetic effects, during their growth, dermoid and epidermoid cysts can cause disturbances in the eye motility, and in rare cases, also an optical nerve compression syndrome. In this paper, we described a child with a congenital orbital dermoid cyst localized in the upper-nasal quadrant that was showing signs of a gradual enlargement and progression. The computerized tomography revealed a cyst of 1.5-2.0 cm in size. At the Maxillofacial Surgery Hospital in Nis, the dermoid cyst was extirpated in toto after orbitotomy performed by superciliary approach. Postoperative course was uneventful, without inflammation signs, and after two weeks excellent functional and aesthetic effects were achieved. Before the decision to treat the dermoid and epidermoid cysts operatively, a detailed diagnostic procedure was necessary to be done in order to locate the cyst precisely and determine its size and possible propagation into the surrounding periorbital structures. Apart from cosmetic indications, operative procedures are recommended in the case of cysts with constant progressions, which cause the pressure to the eye lobe, lead to motility disturbances and indirectly compress the optical nerve and branches of the cranial nerves III, IV and VI.

  2. Comparison of Scheimpflug imaging and spectral domain anterior segment optical coherence tomography for detection of narrow anterior chamber angles

    PubMed Central

    Grewal, D S; Brar, G S; Jain, R; Grewal, S P S

    2011-01-01

    Purpose To compare the performance of anterior chamber volume (ACV) and anterior chamber depth (ACD) obtained using Scheimpflug imaging with angle opening distance (AOD500) and trabecular-iris space area (TISA500) obtained using spectral domain anterior segment optical coherence tomography (SD-ASOCT) in detecting narrow angles classified using gonioscopy. Methods In this prospective, cross-sectional observational study, 265 eyes of 265 consecutive patients underwent sequential Scheimpflug imaging, SD-ASOCT imaging, and gonioscopy. Correlations between gonioscopy grading, ACV, ACD, AOD500, and TISA500 were evaluated. Area under receiver operating characteristic curve (AUC), sensitivity, specificity, and likelihood ratios (LRs) were calculated to assess the performance of ACV, ACD, AOD500, and TISA500 in detecting narrow angles (defined as Shaffer grade ≤1 in all quadrants). SD-ASOCT images were obtained at the nasal and temporal quadrants only. Results Twenty-eight eyes (10.6%) were classified as narrow angles on gonioscopy. ACV correlated with gonioscopy grading (P<0.001) for temporal (r=0.204), superior (r=0.251), nasal (r=0.213), and inferior (r=0.236) quadrants. ACV correlated with TISA500 for nasal (r=0.135, P=0.029) and temporal (P=0.160, P=0.009) quadrants and also with AOD500 for nasal (r=0.498, P<0.001) and temporal (r=0.517, P<0.001) quadrants. For detection of narrow angles, ACV (AUC=0.935; 95% confidence interval (CI) =0.898–0.961) performed similar to ACD (AUC=0.88, P=0.06) and significantly better than AOD500 nasal (AUC=0.761, P=0.001), AOD500 temporal (AUC=0.808, P<0.001), TISA500 nasal (AUC=0.756, P<0.001), and TISA500 temporal (AUC=0.738, P<0.001). Using a cutoff of 113 mm3, ACV had 90% sensitivity and 88% specificity for detecting narrow angles. Positive and negative LRs for ACV were 8.63 (95% CI=7.4–10.0) and 0.11 (95% CI=0.03–0.4), respectively. Conclusions ACV measurements using Scheimpflug imaging outperformed AOD500 and TISA500 using SD-ASOCT for detecting narrow angles. PMID:21336254

  3. Retinal thickness changes after phacoemulsification

    PubMed Central

    Pardianto, Gede; Moeloek, Nila; Reveny, Julia; Wage, Sutarman; Satari, Imsyah; Sembiring, Rosita; Srisamran, Nuttamon

    2013-01-01

    Purpose To determine the effect of phacoemulsification on macular volume and thickness using spectral domain optical coherence tomography examinations. Methods Twenty-seven eyes of 27 subjects who underwent phacoemulsification were studied. All nine areas of the macula were examined by spectral domain optical coherence tomography preoperatively and 2 months postoperatively. Effective phacoemulsification time and absolute phacoemulsification time were also recorded. Results There were statistically significant differences in macular thickness between preoperative and postoperative spectral domain optical coherence tomography examinations in nine areas including macular volume. In the paracentral macular area, the thickness of three quadrants significantly increased (superior P=0.015; temporal P=0.001; and nasal P=0.023). Peripheral macular thickness also increased significantly in the superior (P=0.05) and temporal macular areas (P<0.001). The macular volume increased significantly after phacoemulsification (P<0.001). There were no correlations between absolute/effective phacoemulsification time and macular cellular structures (P>0.05), but a significant correlation (P=0.011) was found between absolute phacoemulsification time and change in macular volume. Conclusion Macular thickness changes in the nasal, superior, and temporal quadrants of the paracentral area and the superior and temporal quadrants of the peripheral area, as well as macular volume, may be used as detailed biomarkers to measure the effects of intraocular pressure fluctuations and maneuvers in phacoemulsification intraocular surgeries. PMID:24235812

  4. Earth observation taken by the Expedition 29 crew

    NASA Image and Video Library

    2011-11-16

    ISS029-E-042846 (16 Nov. 2011) --- Parts of the U.S. and Mexico are seen in this image photographed by one of the Expedition 29 crew members from the International Space Station as it flew above the Pacific Ocean on Nov. 16, 2011. The Salton Sea is in the center of the frame, with the Gulf of Cortez, Mexico's Baja California and the Colorado River in the upper right quadrant. The Los Angeles Basin and Santa Catalina and San Clemente islands are at the bottom center edge of the image. Lake Mead and the Las Vegas area of Nevada even made it into the frame in the upper left quadrant.

  5. Measures of shoulder protraction and thoracolumbar rotation.

    PubMed

    Schenkman, M; Laub, K C; Kuchibhatla, M; Ray, L; Shinberg, M

    1997-05-01

    Physical therapists need objective measures that can be used reliably with a variety of subject groups to document upper quadrant function. Two aspects of upper quadrant motion, shoulder protraction and thoracolumbar rotation, are assessed routinely in clinical practice, but no standard measurement techniques have been reported. We hypothesized that there would be significant differences, by age and state of health, for both shoulder protraction and thoracolumbar rotation. The purposes of this study were: 1) to develop measurement approaches for shoulder protraction and thoracolumbar rotation; 2) to determine if there are significant differences in these motions for four subject groups: healthy young, healthy elders, functionally limited elders, and people with Parkinson's disease; and 3) to describe between-rater and within-rater reliability for these measures. Fifty-five subjects participated in this investigation. All subjects were rated by a physical therapist and two research assistants. Using an analysis of variance followed by Scheffe's post hoc analysis, significant differences were demonstrated between the groups. Between-rater and within-rater reliability ranged from ICCs of 0.54 to 0.95. Clinicians can use these measures to quantify aspects of upper quadrant function treated routinely in physical therapy practice. These measures also have applicability for researchers.

  6. Comparison of quadrant-specific breast cancer incidence trends in the United States and England between 1975 and 2013.

    PubMed

    Bright, C J; Rea, D W; Francis, A; Feltbower, R G

    2016-10-01

    UK breast cancer incidence rates suggest that upper outer quadrant (UOQ) cancers have risen disproportionately compared with other areas over time. We aimed to provide a comparison of the trend in quadrant-specific breast cancer incidence between the United States (US) and England, and determine whether a disproportionate UOQ increase is present. Surveillance Epidemiology and End Results (SEER) cancer registry data were obtained on 630,007 female breast cancers from 1975 to 2013. English cancer registry data were obtained on 1,121,134 female breast cancers from 1979 to 2013. Temporal incidence changes were analysed using negative binomial regression. Interaction terms determined whether incidence changes were similar between sites. English breast cancer incidence in the UOQ rose significantly from 13% to 28% from 1979 to 2013 whereas no significant increase was observed among SEER data. The significant interaction between quadrant and year of diagnosis (p<0.001) in both SEER and English data indicates that breast cancer incidence in each quadrant changed at a different rate. Incidence in the UOQ rose disproportionately compared to the nipple (SEER IRR=0.81, p<0.001; England IRR=0.78, p<0.001) and axillary tail (SEER IRR=0.87, p=0.018; England IRR=0.69, p<0.001) in both SEER and England. In addition, incidence rose disproportionately in the UOQ compared to non-site-specific tumours in England (Overlapping lesions IRR=0.81, p=0.002; NOS IRR=0.78, p<0.001). The proportion of non-site-specific tumours was substantially higher in England than SEER throughout the study period (62% in England; 39% in SEER). Breast cancer incidence in the UOQ increased disproportionately compared to non-site-specific tumours in England but not in SEER, likely due to the decrease in non-site-specific tumours observed in England over time. There may be real differences in incidence between the two countries, possibly due to differences in aetiology, but is much more likely to be an artefact of changing data collection methods and improvements in site coding in either country. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Earth Observations taken by STS-115 crewmember

    NASA Image and Video Library

    2006-09-19

    S115-E-07595 (19 Sept. 2006) --- A crewmember aboard the Space Shuttle Atlantis recorded this digital still image of part of the eastern Mediterranean area. The Gulf of Suez, Gulf of Aqaba, Dead Sea, Tel Aviv and Jerusalem all are visible in the upper left quadrant. Jordan is in the lower left quadrant. The Golan Heights and Haifa appear in the lower right quarter.

  8. Extent of resection in temporal lobectomy for epilepsy. II. Memory changes and neurologic complications.

    PubMed

    Katz, A; Awad, I A; Kong, A K; Chelune, G J; Naugle, R I; Wyllie, E; Beauchamp, G; Lüders, H

    1989-01-01

    We present correlations of extent of temporal lobectomy for intractable epilepsy with postoperative memory changes (20 cases) and abnormalities of visual field and neurologic examination (45 cases). Postoperative magnetic resonance imaging (MRI) in the coronal plane was used to quantify anteroposterior extent of resection of various quadrants of the temporal lobe, using a 20-compartment model of that structure. The Wechsler Memory Scale-Revised (WMS-R) was administered preoperatively and postoperatively. Postoperative decrease in percentage of retention of verbal material correlated with extent of medial resection of left temporal lobe, whereas decrease in percentage of retention of visual material correlated with extent of medial resection of right temporal lobe. These correlations approached but did not reach statistical significance. Extent of resection correlated significantly with the presence of visual field defect on perimetry testing but not with severity, denseness, or congruity of the defect. There was no correlation between postoperative dysphasia and extent of resection in any quadrant. Assessment of extent of resection after temporal lobectomy allows a rational interpretation of postoperative neurologic deficits in light of functional anatomy of the temporal lobe.

  9. Evaluation of anterior chamber angle under dark and light conditions in angle closure glaucoma: An anterior segment OCT study.

    PubMed

    Masoodi, Habibeh; Jafarzadehpur, Ebrahim; Esmaeili, Alireza; Abolbashari, Fereshteh; Ahmadi Hosseini, Seyed Mahdi

    2014-08-01

    To evaluate changes of nasal and temporal anterior chamber angle (ACA) in subjects with angle closure glaucoma using Spectralis AS-OCT (SAS-OCT) under dark and light conditions. Based on dark-room gonioscopy, 24 subjects with open angles and 86 with narrow angles participated in this study. The nasal and temporal angle opening distance at 500 μm anterior to the scleral spur (AOD500), nasal and temporal ACA were measured using SAS-OCT in light and dark conditions. In 2 groups, ACA and AOD500 in nasal and temporal quadrants were significantly greater in light compared to dark (all with p=0.000). The AOD500 and ACA were significantly higher in nasal than temporal in measured conditions for 2 groups except the ACA and AOD500 of normal group measured in light. The difference between nasal and temporal in dark (29.07 ± 65.71 μm for AOD500 and 5.7 ± 4.07° for ACA) was greater than light (24.86 ± 79.85 μm for AOD500 and 2.09 ± 7.21° for ACA) condition. But the difference was only significant for ACA (p=0.000). The correlation analysis showed a negative correlation between AOD500 and pupil diameter in temporal and nasal quadrants (both with p=0.000). While temporal AOD500 difference correlated with spherical equivalent, temporal and asal gonioscopy, nasal AOD correlated with IOP, temporal and nasal gonioscopy. Clinically important changes in ACA structure could be detected with SAS-OCT in nasal and temporal quadrants under different illumination intensity. The results could help in improvement of examination condition for better and more accurate assessment of individuals with angle closure glaucoma. Copyright © 2014 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  10. Tumour location within the breast: Does tumour site have prognostic ability?

    PubMed

    Rummel, Seth; Hueman, Matthew T; Costantino, Nick; Shriver, Craig D; Ellsworth, Rachel E

    2015-01-01

    Tumour location within the breast varies with the highest frequency in the upper outer quadrant (UOQ) and lowest frequency in the lower inner quadrant (LIQ). Whether tumour location is prognostic is unclear. To determine whether tumour location is prognostic, associations between tumour site and clinicopathological characteristics were evaluated. All patients enrolled in the Clinical Breast Care Project whose tumour site-UOQ, upper inner quadrant (UIQ), central, LIQ, lower outer quadrant (LOQ)-was determined by a single, dedicated breast pathologist were included in this study. Patients with multicentric disease (n = 122) or tumours spanning multiple quadrants (n = 381) were excluded from further analysis. Clinicopathological characteristics were analysed using chi-square tests for univariate analysis with multivariate analysis performed using principal components analysis (PCA) and multiple logistic regression. Significance was defined as P < 0.05. Of the 980 patients with defined tumour location, 30 had bilateral disease. Tumour location in the UOQ (51.5%) was significantly higher than in the UIQ (15.6%), LOQ (14.2%), central (10.6%), or LIQ (8.1%). Tumours in the central quadrant were significantly more likely to have higher tumour stage (P = 0.003) and size (P < 0.001), metastatic lymph nodes (P < 0.001), and mortality (P = 0.011). After multivariate analysis, only tumour size and lymph node status remained significantly associated with survival. Evaluation of tumour location as a prognostic factor revealed that although tumours in the central region are associated with less favourable outcome, these associations are not independent of location but rather driven by larger tumour size. Tumours in the central region are more difficult to detect mammographically, resulting in larger tumour size at diagnosis and thus less favourable prognosis. Together, these data demonstrate that tumour location is not an independent prognostic factor.

  11. Unusual case of acute appendicitis with left upper quadrant abdominal pain.

    PubMed

    Tawk, Charbel M; Zgheib, Rana R; Mehanna, Seba

    2012-01-01

    Acute appendicitis is one of the most frequent causes of surgical abdominal pain presenting to the Emergency Department. The diagnosis is confirmed by a set of clinical signs, blood tests and imaging. The typical presentation consists of periumbilical pain radiating to the right lower quadrant with peritoneal reaction on palpation (Mac Burney). In this article, we report a case of acute appendicitis presenting with a left upper quadrant pain due to intestinal malrotation and we describe the radiologic findings on computed tomography. With an Alvarado score of 4 and a nonconclusive abdominal U/S, the diagnosis of acute appendicitis was a long shot. Persistence of pain and increasing inflammatory parameters in her blood exams pushed the medical team to further investigate and a CT scan revealed intestinal malrotation with acute appendicitis. An examining physician should not be mislead by the atypical presentation of acute appendicitis and should bear in mind the diagnosis to avoid serious complications. Copyright © 2012 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  12. Contralateral breast metastasis from pulmonary adenocarcinoma: two cases report and literature review

    PubMed Central

    Ji, Fang-Fang; Gao, Peng; Wang, Ji-Gang; Zhao, Jie

    2012-01-01

    Carcinoma metastatic to breast from extra-mammary malignancy is rare and only accounts for 0.4-1.3% of all breast cancer. Two rare cases of single breast metastasis from pulmonary adenocarcinoma were reported here with a brief review of the pertinent literature. The only complaint of the these two female patients was painless breast mass found recently. Most breast metastasis previously reported are present in the upper outer quadrant, however, in our study, one case was found to be located in the lower inner quadrant and the other in the upper inner quadrant. Tumor cells from breast biopsy were immune-positive for thyroid transcription factor-1. The two patients survived 5 and 8 months, respectively, following the diagnosis of both the primary lung tumor and the breast metastasis. Breast metastasis from lung adenocarcinoma is rare but does exist. The awareness of this possibility may help to differentiate the tumor from primary breast carcinoma. Clinical history and immunohistochemical studies are essential to reach the final diagnosis. PMID:22934141

  13. The Comparison of Regional RNFL and Fundus Vasculature by OCTA in Chinese Myopia Population.

    PubMed

    Li, Yuanjun; Miara, Hamza; Ouyang, Pingbo; Jiang, Bing

    2018-01-01

    To determine the correlations between peripapillary vessel density, retinal nerve fibre layer (RNFL) thickness, and myopic indices at retina quadrants with optical coherence tomography angiography (OCTA) in Chinese. Fifty-six subjects with a mean spherical equivalent (MSE) of -3.63 ± 0.29 D were included. Peripapillary RNFL thickness and retinal vessel density in four sectors (superior, nasal, inferior, and temporal quadrants) were determined by OCTA, and correlations of the main outcomes were analyzed. Negative correlations were found between the peripapillary RNFL thickness and axial length (AL) at superior ( r = -0.335, P = 0.001) and inferior ( r = -0.551, P < 0.001) quadrants. There was a significant positive correlation with spherical equivalent (SE) at the corresponding quadrants as well as at the nasal quadrant ( r = 0.339, P = 0.001; r = 0.379, P < 0.001; and r = 0.209, P = 0.039, resp.). Peripapillary retinal vessel density was also negatively correlated with AL at the nasal quadrant ( r = -0.392, P < 0.001), and only at the nasal quadrant, there was a positive correlation between the peripapillary vessel density and SE ( r = 0.319, P = 0.001). The degree of myopia and elongation of AL were negatively correlated with peripapillary RNFL thickness at superior and inferior quadrants and with peripapillary retinal vessel density at the nasal quadrant.

  14. The Comparison of Regional RNFL and Fundus Vasculature by OCTA in Chinese Myopia Population

    PubMed Central

    2018-01-01

    Purpose To determine the correlations between peripapillary vessel density, retinal nerve fibre layer (RNFL) thickness, and myopic indices at retina quadrants with optical coherence tomography angiography (OCTA) in Chinese. Methods Fifty-six subjects with a mean spherical equivalent (MSE) of −3.63 ± 0.29 D were included. Peripapillary RNFL thickness and retinal vessel density in four sectors (superior, nasal, inferior, and temporal quadrants) were determined by OCTA, and correlations of the main outcomes were analyzed. Results Negative correlations were found between the peripapillary RNFL thickness and axial length (AL) at superior (r = −0.335, P = 0.001) and inferior (r = −0.551, P < 0.001) quadrants. There was a significant positive correlation with spherical equivalent (SE) at the corresponding quadrants as well as at the nasal quadrant (r = 0.339, P = 0.001; r = 0.379, P < 0.001; and r = 0.209, P = 0.039, resp.). Peripapillary retinal vessel density was also negatively correlated with AL at the nasal quadrant (r = −0.392, P < 0.001), and only at the nasal quadrant, there was a positive correlation between the peripapillary vessel density and SE (r = 0.319, P = 0.001). Conclusions The degree of myopia and elongation of AL were negatively correlated with peripapillary RNFL thickness at superior and inferior quadrants and with peripapillary retinal vessel density at the nasal quadrant. PMID:29651341

  15. Gallbladder Agenesis with Refractory Choledocholithiasis.

    PubMed

    Tjaden, Jamie; Patel, Kevin; Aadam, Aziz

    2015-01-01

    Congenital agenesis of the gallbladder is a rare anomaly which is usually asymptomatic and found incidentally. In some cases, however, patients are symptomatic. Common symptoms include right upper quadrant abdominal pain, nausea, and vomiting. Jaundice is present in some symptomatic cases and is due to associated choledocholithiasis (Fiaschetti et al. 2009). In this case, a 63-year-old female presents with jaundice and episodic right upper quadrant abdominal pain with nausea and vomiting. Bilirubin and alkaline phosphatase were found to be markedly elevated. Upper endoscopic ultrasound (EUS) revealed choledocholithiasis, and the patient required multiple endoscopic retrograde cholangiopancreatography (ERCP) sessions before successful extraction of all stones. Subsequent surgical exploration revealed congenital agenesis of the gallbladder. Although this is a rare finding, patients with agenesis of the gallbladder are at increased risk of developing de novo choledocholithiasis which may be challenging to extract.

  16. 3D MRI for Quantitative Analysis of Quadrant Percent Breast Density: Correlation with Quadrant Location of Breast Cancer.

    PubMed

    Chen, Jeon-Hor; Liao, Fuyi; Zhang, Yang; Li, Yifan; Chang, Chia-Ju; Chou, Chen-Pin; Yang, Tsung-Lung; Su, Min-Ying

    2017-07-01

    Breast cancer occurs more frequently in the upper outer (UO) quadrant, but whether this higher cancer incidence is related to the greater amount of dense tissue is not known. Magnetic resonance imaging acquires three-dimensional volumetric images and is the most suitable among all breast imaging modalities for regional quantification of density. This study applied a magnetic resonance imaging-based method to measure quadrant percent density (QPD), and evaluated its association with the quadrant location of the developed breast cancer. A total of 126 cases with pathologically confirmed breast cancer were reviewed. Only women who had unilateral breast cancer located in a clear quadrant were selected for analysis. A total of 84 women, including 47 Asian women and 37 western women, were included. An established computer-aided method was used to segment the diseased breast and the contralateral normal breast, and to separate the dense and fatty tissues. Then, a breast was further separated into four quadrants using the nipple and the centroid as anatomic landmarks. The tumor was segmented using a computer-aided method to determine its quadrant location. The distribution of cancer quadrant location, the quadrant with the highest QPD, and the proportion of cancers occurring in the highest QPD were analyzed. The highest incidence of cancer occurred in the UO quadrant (36 out of 84, 42.9%). The highest QPD was also noted most frequently in the UO quadrant (31 out of 84, 36.9%). When correlating the highest QPD with the quadrant location of breast cancer, only 17 women out of 84 (20.2%) had breast cancer occurring in the quadrant with the highest QPD. The results showed that the development of breast cancer in a specific quadrant could not be explained by the density in that quadrant, and further studies are needed to find the biological reasons accounting for the higher breast cancer incidence in the UO quadrant. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  17. CT enterography: Mannitol versus VoLumen.

    PubMed

    Wong, Jessica; Moore, Helen; Roger, Mark; McKee, Chris

    2016-10-01

    Several different neutral oral contrast agents have been trialled in magnetic resonance and CT enterography (CTE). In the Auckland region, Mannitol 2.5% and VoLumen are both used in CTE. This study compares the performance of these two neutral oral contrast agents in CTE. Computed tomography enterography data were collected from 25 consecutive studies that used either Mannitol or VoLumen in 2014. All images were reviewed by three radiologists blinded to the type of oral contrast. Each quadrant was assessed for maximum distension, proportion of bowel loops distended, presence of inhomogeneous content and bowel wall visibility. Assessment also included whether the contrast agent reached the caecum and an overall subjective quality assessment. Patients were invited to answer a questionnaire regarding tolerability of the preparations. Mannitol achieves better wall visibility in the right upper quadrant, left upper quadrant and left lower quadrant (P < 0.01). Overall differences in study quality favours Mannitol (P < 0.01) with 48% of the Mannitol studies being considered excellent compared with 4% of the VoLumen studies. There was no difference in maximal distension or proportion of loops distended. Mannitol in CTE achieves studies of a better quality than and is a viable alternative to VoLumen. © 2016 The Royal Australian and New Zealand College of Radiologists.

  18. The relationship between contrast sensitivity and retinal nerve fiber layer thickness in patients with glaucoma.

    PubMed

    Amanullah, Sarah; Okudolo, Joseph; Rahmatnejad, Kamran; Lin, Shuai-Chun; Wizov, Sheryl S; Manzi Muhire, Remy S; Hark, Lisa A; Zheng, Cindy X; Zhan, Tingting; Spaeth, George L

    2017-12-01

    To evaluate the correlation between contrast sensitivity (CS) and retinal nerve fiber layer (RNFL) in different areas of vision. This report is a sub-analysis of a prospective, observational cohort study investigating changes in performance-based assessment, vision-related quality of life, and clinical measures in patients with moderate to advanced glaucoma. The study included 161 participants with at least a 2-year history of glaucoma who underwent annual testing for 4 years. Contrast sensitivity was measured using the Spaeth/Richman contrast sensitivity (SPARCS) test, while RNFL thickness (RNFLT) was measured using Cirrus optical coherence tomography (OCT). Statistical analyses were performed to determine correlations between CS and RNFLT; the correlations were calculated for each annual visit, totaling four correlation coefficients for each patient over the course of 4 years. The SPARCS score in the left upper area of vision correlated the most strongly with the RNFLT of the inferior quadrant for both eyes at each annual visit, specifically in the seven o'clock sector for the left eye and the six o'clock sector for the right eye (p < 0.05). There were no discernible trends for the correlations between the other areas of CS and RNFL quadrants or clock hours over the 4 years of the study. Linear regression between the SPARCS total score and average RNFLT showed a significant direct correlation at each visit (p < 0.01). Contrast sensitivity in the left upper area of vision for both eyes correlated most strongly with the thickness of the inferior quadrant of the RNFL. These fibers project to the temporal portion of the right occipital lobe, implying a potential center for contrast perception in this area. The longitudinal nature of the study suggests that CS may be a predictive tool for changes in RNFL in patients with glaucoma. Despite this finding, retinal damage and its relationship to CS was diffuse. In addition, SPARCS was shown to predict RNFLT. Further research is warranted to understand how CS can be used as a tool in the clinical setting.

  19. Retina ganglion cell/inner plexiform layer and peripapillary nerve fiber layer thickness in patients with acromegaly.

    PubMed

    Şahin, Muhammed; Şahin, Alparslan; Kılınç, Faruk; Yüksel, Harun; Özkurt, Zeynep Gürsel; Türkcü, Fatih Mehmet; Pekkolay, Zafer; Soylu, Hikmet; Çaça, İhsan

    2017-06-01

    Increased secretion of growth hormone and insulin-like growth factor-1 in acromegaly has various effects on multiple organs. However, the ocular effects of acromegaly have yet to be investigated in detail. The aim of the present study was to compare retina ganglion cell/inner plexiform layer (GCIPL) and peripapillary nerve fiber layer thickness (pRNFL) between patients with acromegaly and healthy control subjects using spectral domain optical coherence tomography (SD-OCT). This cross-sectional, comparative study included 18 patients with acromegaly and 20 control subjects. All participants underwent SD-OCT to measure pRNFL (in the seven peripapillary areas), GCIPL (in the nine ETDRS areas), and central macular thickness (CMT). Visual field (VF) examinations were performed using a Humphrey field analyzer in acromegalic patients. Measurements were compared between patients with acromegaly and control subjects. A total of 33 eyes of 18 patients with acromegaly and 40 eyes of 20 control subjects met the inclusion criteria of the present study. The overall calculated average pRNFL thickness was significantly lower in patients with acromegaly than in control subjects (P = 0.01), with pRNFL thickness significantly lower in the temporal superior and temporal inferior quadrants. Contrary to our expectations, pRNFL thickness in the nasal quadrant was similar between acromegalic and control subjects. The mean overall pRNFL thickness and superonasal, nasal, inferonasal, and inferotemporal quadrant pRNFL thicknesses were found to correlate with the mean deviation (MD) according to Spearman's correlation. However, other quadrants were not correlated with VF sensitivity. No significant difference in CMT values was observed (P = 0.6). GCIPL thickness was significantly lower in all quadrants of the inner and outer macula, except for central and inferior outer quadrants, in the acromegaly group than that in the control group (P < 0.05). GCIPL thicknesses of the inferior inner and outer macula quadrants were found to correlate with MD, whereas no correlation was observed between other quadrants and VF sensitivity. We demonstrated that GCIPL thickness decreased in patients with acromegaly compared with that in control subjects. However, the nasal quadrant pRNFL thickness was similar in acromegaly, in contrast to our expectations. SD-OCT may have utility in the assessment of the effects of acromegaly on retinal structures.

  20. Quadrantal multi-scale distribution entropy analysis of heartbeat interval series based on a modified Poincaré plot

    NASA Astrophysics Data System (ADS)

    Huo, Chengyu; Huang, Xiaolin; Zhuang, Jianjun; Hou, Fengzhen; Ni, Huangjing; Ning, Xinbao

    2013-09-01

    The Poincaré plot is one of the most important approaches in human cardiac rhythm analysis. However, further investigations are still needed to concentrate on techniques that can characterize the dispersion of the points displayed by a Poincaré plot. Based on a modified Poincaré plot, we provide a novel measurement named distribution entropy (DE) and propose a quadrantal multi-scale distribution entropy analysis (QMDE) for the quantitative descriptions of the scatter distribution patterns in various regions and temporal scales. We apply this method to the heartbeat interval series derived from healthy subjects and congestive heart failure (CHF) sufferers, respectively, and find that the discriminations between them are most significant in the first quadrant, which implies significant impacts on vagal regulation brought about by CHF. We also investigate the day-night differences of young healthy people, and it is shown that the results present a clearly circadian rhythm, especially in the first quadrant. In addition, the multi-scale analysis indicates that the results of healthy subjects and CHF sufferers fluctuate in different trends with variation of the scale factor. The same phenomenon also appears in circadian rhythm investigations of young healthy subjects, which implies that the cardiac dynamic system is affected differently in various temporal scales by physiological or pathological factors.

  1. Photocopy of aerial photograph, Pacific Air Industries, Flight 123V, June ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of aerial photograph, Pacific Air Industries, Flight 123V, June 29, 1960 (University of California, Santa Barbara, Map and Imagery Collection) PORTION OF IRVINE RANCH SHOWING SITE CA-2275-A IN LOWER LEFT QUADRANT AND SITE CA-2275-B IN UPPER RIGHT QUADRANT (see separate photograph index for 2275-B) - Irvine Ranch Agricultural Headquarters, Carillo Tenant House, Southwest of Intersection of San Diego & Santa Ana Freeways, Irvine, Orange County, CA

  2. Multifocal Visual Evoked Potential in Eyes With Temporal Hemianopia From Chiasmal Compression: Correlation With Standard Automated Perimetry and OCT Findings.

    PubMed

    Sousa, Rafael M; Oyamada, Maria K; Cunha, Leonardo P; Monteiro, Mário L R

    2017-09-01

    To verify whether multifocal visual evoked potential (mfVEP) can differentiate eyes with temporal hemianopia due to chiasmal compression from healthy controls. To assess the relationship between mfVEP, standard automated perimetry (SAP), and Fourier domain-optical coherence tomography (FD-OCT) macular and peripapillary retinal nerve fiber layer (RNFL) thickness measurements. Twenty-seven eyes with permanent temporal visual field (VF) defects from chiasmal compression on SAP and 43 eyes of healthy controls were submitted to mfVEP and FD-OCT scanning. Multifocal visual evoked potential was elicited using a stimulus pattern of 60 sectors and the responses were averaged for the four quadrants and two hemifields. Optical coherence tomography macular measurements were averaged in quadrants and halves, while peripapillary RNFL thickness was averaged in four sectors around the disc. Visual field loss was estimated in four quadrants and each half of the 24-2 strategy test points. Multifocal visual evoked potential measurements in the two groups were compared using generalized estimated equations, and the correlations between mfVEP, VF, and OCT findings were quantified. Multifocal visual evoked potential-measured temporal P1 and N2 amplitudes were significantly smaller in patients than in controls. No significant difference in amplitude was observed for nasal parameters. A significant correlation was found between mfVEP amplitudes and temporal VF loss, and between mfVEP amplitudes and the corresponding OCT-measured macular and RNFL thickness parameters. Multifocal visual evoked potential amplitude parameters were able to differentiate eyes with temporal hemianopia from controls and were significantly correlated with VF and OCT findings, suggesting mfVEP is a useful tool for the detection of visual abnormalities in patients with chiasmal compression.

  3. Determination of retinal surface area.

    PubMed

    Nagra, Manbir; Gilmartin, Bernard; Thai, Ngoc Jade; Logan, Nicola S

    2017-09-01

    Previous attempts at determining retinal surface area and surface area of the whole eye have been based upon mathematical calculations derived from retinal photographs, schematic eyes and retinal biopsies of donor eyes. 3-dimensional (3-D) ocular magnetic resonance imaging (MRI) allows a more direct measurement, it can be used to image the eye in vivo, and there is no risk of tissue shrinkage. The primary purpose of this study is to compare, using T2-weighted 3D MRI, retinal surface areas for superior-temporal (ST), inferior-temporal (IT), superior-nasal (SN) and inferior-nasal (IN) retinal quadrants. An ancillary aim is to examine whether inter-quadrant variations in area are concordant with reported inter-quadrant patterns of susceptibility to retinal breaks associated with posterior vitreous detachment (PVD). Seventy-three adult participants presenting without retinal pathology (mean age 26.25 ± 6.06 years) were scanned using a Siemens 3-Tesla MRI scanner to provide T2-weighted MR images that demarcate fluid-filled internal structures for the whole eye and provide high-contrast delineation of the vitreous-retina interface. Integrated MRI software generated total internal ocular surface area (TSA). The second nodal point was used to demarcate the origin of the peripheral retina in order to calculate total retinal surface area (RSA) and quadrant retinal surface areas (QRSA) for ST, IT, SN, and IN quadrants. Mean spherical error (MSE) was -2.50 ± 4.03D and mean axial length (AL) 24.51 ± 1.57 mm. Mean TSA and RSA for the RE were 2058 ± 189 and 1363 ± 160 mm 2 , respectively. Repeated measures anova for QRSA data indicated a significant difference within-quadrants (P < 0.01) which, contrasted with ST (365 ± 43 mm 2 ), was significant for IT (340 ± 40 mm 2 P < 0.01), SN (337 ± 40 mm 2 P < 0.01) and IN (321 ± 39 mm 2 P < 0.01) quadrants. For all quadrants, QRSA was significantly correlated with AL (P < 0.01) and exhibited equivalent increases in retinal area/mm increase in AL. Although the differences between QRSAs are relatively small, there was evidence of concordance with reported inter-quadrant patterns of susceptibility to retinal breaks associated with PVD. The data allow AL to be converted to QRSAs, which will assist further work on inter-quadrant structural variation. © 2017 Anatomical Society.

  4. Collagen Fiber Orientation and Dispersion in the Upper Cervix of Non-Pregnant and Pregnant Women

    PubMed Central

    Myers, Kristin M.; Vink, Joy Y.; Wapner, Ronald J.; Hendon, Christine P.

    2016-01-01

    The structural integrity of the cervix in pregnancy is necessary for carrying a pregnancy until term, and the organization of human cervical tissue collagen likely plays an important role in the tissue’s structural function. Collagen fibers in the cervical extracellular matrix exhibit preferential directionality, and this collagen network ultrastructure is hypothesized to reorient and remodel during cervical softening and dilation at time of parturition. Within the cervix, the upper half is substantially loaded during pregnancy and is where the premature funneling starts to happen. To characterize the cervical collagen ultrastructure for the upper half of the human cervix, we imaged whole axial tissue slices from non-pregnant and pregnant women undergoing hysterectomy or cesarean hysterectomy respectively using optical coherence tomography (OCT) and implemented a pixel-wise fiber orientation tracking method to measure the distribution of fiber orientation. The collagen fiber orientation maps show that there are two radial zones and the preferential fiber direction is circumferential in a dominant outer radial zone. The OCT data also reveal that there are two anatomic regions with distinct fiber orientation and dispersion properties. These regions are labeled: Region 1—the posterior and anterior quadrants in the outer radial zone and Region 2—the left and right quadrants in the outer radial zone and all quadrants in the inner radial zone. When comparing samples from nulliparous vs multiparous women, no differences in these fiber properties were noted. Pregnant tissue samples exhibit an overall higher fiber dispersion and more heterogeneous fiber properties within the sample than non-pregnant tissue. Collectively, these OCT data suggest that collagen fiber dispersion and directionality may play a role in cervical remodeling during pregnancy, where distinct remodeling properties exist according to anatomical quadrant. PMID:27898677

  5. Visual field defects after temporal lobe resection for epilepsy.

    PubMed

    Steensberg, Alvilda T; Olsen, Ane Sophie; Litman, Minna; Jespersen, Bo; Kolko, Miriam; Pinborg, Lars H

    2018-01-01

    To determine visual field defects (VFDs) using methods of varying complexity and compare results with subjective symptoms in a population of newly operated temporal lobe epilepsy patients. Forty patients were included in the study. Two patients failed to perform VFD testing. Humphrey Field Analyzer (HFA) perimetry was used as the gold standard test to detect VFDs. All patients performed a web-based visual field test called Damato Multifixation Campimetry Online (DMCO). A bedside confrontation visual field examination ad modum Donders was extracted from the medical records in 27/38 patients. All participants had a consultation by an ophthalmologist. A questionnaire described the subjective complaints. A VFD in the upper quadrant was demonstrated with HFA in 29 (76%) of the 38 patients after surgery. In 27 patients tested ad modum Donders, the sensitivity of detecting a VFD was 13%. Eight patients (21%) had a severe VFD similar to a quadrant anopia, thus, questioning their permission to drive a car. In this group of patients, a VFD was demonstrated in one of five (sensitivity=20%) ad modum Donders and in seven of eight (sensitivity=88%) with DMCO. Subjective symptoms were only reported by 28% of the patients with a VFD and in two of eight (sensitivity=25%) with a severe VFD. Most patients (86%) considered VFD information mandatory. VFD continue to be a frequent adverse event after epilepsy surgery in the medial temporal lobe and may affect the permission to drive a car in at least one in five patients. Subjective symptoms and bedside visual field testing ad modum Donders are not sensitive to detect even a severe VFD. Newly developed web-based visual field test methods appear sensitive to detect a severe VFD but perimetry remains the golden standard for determining if visual standards for driving is fulfilled. Patients consider VFD information as mandatory. Copyright © 2017. Published by Elsevier Ltd.

  6. Diagnostic Power of Macular Retinal Thickness Analysis and Structure-Function Relationship in Glaucoma Diagnosis Using SPECTRALIS OCT.

    PubMed

    Rolle, Teresa; Manerba, Linda; Lanzafame, Pietro; Grignolo, Federico M

    2016-05-01

    To evaluate the diagnostic power of the Posterior Pole Asymmetry Analysis (PPAA) from the SPECTRALIS OCT in glaucoma diagnosis and to define the correlation between the visual field sensitivity (VFS) and macular retinal thickness (MRT). 90 consecutive open-angle glaucoma patients and 23 healthy subjects were enrolled. All subjects underwent Visual Field test (Humphrey Field Analyzer, central 24-2 SITA-Standard) and SD-OCT volume scans (SPECTRALIS, Posterior Pole Asymmetry Analysis). The areas under the Receiving Operating Characteristic curve (AROC) were calculated to assess discriminating power for glaucoma, at first considering total MRT values and hemisphere MRT value and then quadrant MRT values from 16 square cells in a 8 x 8 posterior pole retinal thickness map that were averaged for a mean retinal thickness value. Structure function correlation was performed for total values, hemisphere values and for each quadrant compared to the matching central test points of the VF. The AROCs ranged from 0.70 to 0.82 (p < 0.0001), with no significant differences between each other. The highest AROC observed was in inferior nasal quadrant. The VFS showed a strong correlation only with the corresponding MRT value s for quadrant analysis: Superior Temporal (r = 0.33, p = 0.0013), Superior Nasal (r = 0.43, p < 0.0001), Inferior Temporal (r = 0.57, p < 0.0001) and Inferior Nasal (r = 0.55, p < 0.0001). the quadrant analysis showed statistically significant structure-function correlations and may provide additional data for the diagnostic performance of SPECTRALIS OCT.

  7. Retinal nerve fiber layer analysis with scanning laser polarimetry and RTVue-OCT in patients of retinitis pigmentosa.

    PubMed

    Xue, Kang; Wang, Min; Chen, Junyi; Huang, Xin; Xu, Gezhi

    2013-01-01

    To measure the thickness of the retinal nerve fiber layer (RNFL) of patients with retinitis pigmentosa (RP) and that of normal controls by scanning laser polarimetry with enhanced corneal compensation (GDxECC) and RTVue-optical coherence tomography (OCT). Fifty-two eyes of 26 patients were included. All patients underwent complete ophthalmological examinations and testing with GDxECC. Twenty-eight of 52 eyes of RP patients underwent RTVue-OCT measurements. A group of 50 eyes of 25 normal subjects (controls) was also included. GDxECC measured RNFL thickness in the peripapillary area in all subjects as well as temporal-superior-nasal-inferior-temporal (TSNIT) parameters, including TSNIT means, superior and inferior region means, TSNIT standard deviation (SD), inter-eye symmetry and nerve fiber indicator (NFI). RTVue-OCT measured the mean, superior, inferior, temporal and nasal quadrant RNFL thickness. In RP patients and controls, TSNIT means by GDxECC were, respectively, 65.00 ± 7.35 and 55.32 ± 5.20. Mean superior quadrant thicknesses were 80.56 ± 10.93 and 69.54 ± 7.45. Mean inferior thicknesses were 80.58 ± 9.34 and 69.12 ± 7.78. SDs were 27.92 ± 5.21 and 28.23 ± 4.01. Inter-eye symmetries were 0.82 ± 0.17 and 0.87 ± 0.09. NFIs were 9.74 ± 8.73 and 16.81 ± 8.13. The differences between mean TSNIT, mean superior and mean inferior quadrant thicknesses and NFIs were statistically significant (p < 0.001). In RTVue-OCT measurements, the differences between mean, superior, inferior and temporal quadrant RNFL thicknesses were statistically significant (p = 0.0322, 0.0213, 0.0387, 0.0005). The RNFL measured by GDxECC was significantly thicker in RP patients than in controls. RNFL thickness measured by RTVue-OCT was significantly greater in RP patients than in controls in the superior, inferior and temporal regions. This contribution provides information on RNFL thickness and discusses the mechanism underlying this phenomenon. Copyright © 2012 S. Karger AG, Basel.

  8. Abdominal mass

    MedlinePlus

    ... lumpy mass in the right upper quadrant. Liver enlargement (hepatomegaly) can cause a firm, irregular mass below ... the kidney (usually only affects one kidney). Spleen enlargement (splenomegaly) can sometimes be felt in the left- ...

  9. Acute pancreatitis in pregnancy: an overview.

    PubMed

    Papadakis, Efstathios P; Sarigianni, Maria; Mikhailidis, Dimitri P; Mamopoulos, Apostolos; Karagiannis, Vasilios

    2011-12-01

    Acute pancreatitis is rare in pregnancy but it is associated with increased incidence of maternal and fetal mortality. It should be considered in the differential diagnosis of upper quadrant abdominal pain with or without nausea and vomiting. The commonest identified causes of acute pancreatitis in pregnancy are gallstones, alcohol and hypertriglyceridemia. The main laboratory finding is increased amylase activity. Appropriate investigations include ultrasound of the right upper quadrant and measurement of serum triglycerides and ionized calcium. Management of gallstone pancreatitis is controversial, although laparoscopic cholecystectomy and endoscopic retrograde cholangiopancreatography (ERCP) are often used and may be associated with lower complication rates. In hypertriglyceridemia-induced acute pancreatitis ω-3 fatty acids and even therapeutic plasma exchange can be used. We also discuss preventive measures. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  10. Retinal Nerve Fiber Layer Thickness Changes in the Pseudoexfoliation Syndrome: A Meta-Analysis of Case-Control Studies.

    PubMed

    Yu, Ji-Guo; Huang, Qing; Zhou, Xiao-Fang; Ding, Yi; Li, Jing; Xiang, Yi

    2018-01-01

    To evaluate and compare changes in retinal nerve fiber layer (RNFL) thickness in patients with the pseudoexfoliation syndrome (PXS) and healthy controls. Case-control studies were selected through an electronic search of the Cochrane Controlled Trials Register, PubMed, and Embase. Results were reviewed to ensure that the included studies met prespecified inclusion/exclusion criteria, and the quality of each study was assessed using the Newcastle-Ottawa Scale. All included studies measured average and 4-quadrant (temporal, superior, nasal, and inferior) RNFL thickness using optical coherence tomography (OCT). For the continuous outcomes, we calculated the weighted mean difference (WMD) and 95% confidence intervals (CIs). Eight case-control studies were included in this meta-analysis involving 225 eyes of PXS patients and 208 eyes of healthy controls in total. Statistical analysis revealed that the average RNFL thickness in PXS patients was significantly reduced compared to healthy controls (WMD = -6.91, 95% CI: -9.99 to -3.82, p < 0.0001). Additionally, differences in RNFL thickness in the superior quadrant (WMD = -10.68, 95% CI: -16.40 to -4.95, p = 0.0003), inferior quadrant (WMD = -8.20, 95% CI: -10.85 to -5.55, p < 0.00001), nasal quadrant (WMD = -3.05, 95% CI: -5.21 to -0.90, p = 0.005), and temporal quadrant (WMD = -6.39, 95% CI: -9.98 to -2.80, p = 0.0005) were all significant between the two groups. These results suggest that it is important to evaluate RNFL thickness and the optic nerve head through OCT in patients with PXS in order to determine early glaucomatous damage and start timely intervention prior to visual field loss. © 2017 S. Karger AG, Basel.

  11. Lack of differences in the regional variation of oxygen saturation in larger retinal vessels in diabetic maculopathy and proliferative diabetic retinopathy.

    PubMed

    Jørgensen, Christina Mørup; Bek, Toke

    2017-06-01

    Diabetic retinopathy is characterised by morphological lesions in the ocular fundus related to disturbances in retinal blood flow. The two vision threatening forms of retinopathy show specific patterns of distribution of retinal lesions with proliferative diabetic retinopathy (PDR) developing secondary to ischaemia and hypoxia in the retinal periphery and diabetic maculopathy (DM) developing secondary to hyperperfusion and increased vascular permeability in the macular area. These differences in the distribution of retinal lesions might be reflected in regional differences in oxygen saturation in the larger retinal vessels. Dual-wavelength retinal oximetry was performed in 30 normal persons, 30 patients with DM and 30 patients with PDR, and the oxygen saturation was measured in peripapillary vessels supplying the four retinal quadrants and in branches from the upper temporal arcades supplying, respectively, the macular area and the retinal periphery. The overall oxygen saturation was significantly higher in diabetic patients than in normal persons and the arteriovenous (AV) saturation difference significantly lower in the patients with DM. The regional variation in oxygen saturation was similar in the three studied groups with a decreasing saturation from the upper nasal through the lower nasal, lower temporal and the upper temporal peripapillary vessels, and with a significantly higher oxygen saturation in venules draining the macular area than in venules draining the retinal periphery. The regional differences in retinal lesions in vision threatening diabetic retinopathy are not reflected in regional differences in the oxygen saturation of larger retinal vessels. The development of vision threatening diabetic retinopathy depends on other factors, such as, for example, regional differences in the retinal microcirculation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  12. Laser Doppler Vibrometry measurements of human cadaveric tympanic membrane vibration

    PubMed Central

    2013-01-01

    Objective To determine the feasibility of measuring tympanic membrane (TM) vibrations at multiple locations on the TM to differentiate normal eardrums from those with associated ossicular pathologies. Design Cadaveric human temporal bone study. Setting Basic science laboratory. Methods A mastoidectomy and facial recess approach was performed on four cadaveric temporal bones to obtain access to the ossicles without disrupting the TM. Ossicles were palpated to ensure normal mobility and an intact ossicular chain. Laser Doppler Vibrometry (LDV) measurements were then taken on all four TMs. LDV measurements were repeated on each TM following stapes footplate fixation, incudo-stapedial joint dislocation, and malleus head fixation. Main outcome measures LDV measurements of TM vibration at the umbo, the lateral process of the malleus, and in each of the four quadrants of the TM. Results The best signal-to-noise ratios were found between 2 and 4 kHz, at the umbo, the anterior superior quadrant, the anterior inferior quadrant, and the posterior inferior quadrant. Since our goal was to assess the ossicular chain, we selected the TM locations closest to the ossicular chain (the umbo and lateral process of the malleus) for further analysis. Differences could be seen between normals and the simulated ossicular pathologies, but values were not statistically significant. Conclusions LDV measurements are technically challenging and require optimization to obtain consistent measurements. This study demonstrates the potential of LDV to differentiate ossicular pathologies behind an intact tympanic membrane. Future studies will further characterize the clinical role of this diagnostic modality. PMID:23663748

  13. Comparison of ultra-widefield fluorescein angiography with the Heidelberg Spectralis(®) noncontact ultra-widefield module versus the Optos(®) Optomap(®).

    PubMed

    Witmer, Matthew T; Parlitsis, George; Patel, Sarju; Kiss, Szilárd

    2013-01-01

    To compare ultra-widefield fluorescein angiography imaging using the Optos(®) Optomap(®) and the Heidelberg Spectralis(®) noncontact ultra-widefield module. Five patients (ten eyes) underwent ultra-widefield fluorescein angiography using the Optos(®) panoramic P200Tx imaging system and the noncontact ultra-widefield module in the Heidelberg Spectralis(®) HRA+OCT system. The images were obtained as a single, nonsteered shot centered on the macula. The area of imaged retina was outlined and quantified using Adobe(®) Photoshop(®) C5 software. The total area and area within each of four visualized quadrants was calculated and compared between the two imaging modalities. Three masked reviewers also evaluated each quadrant per eye (40 total quadrants) to determine which modality imaged the retinal vasculature most peripherally. Optos(®) imaging captured a total retinal area averaging 151,362 pixels, ranging from 116,998 to 205,833 pixels, while the area captured using the Heidelberg Spectralis(®) was 101,786 pixels, ranging from 73,424 to 116,319 (P = 0.0002). The average area per individual quadrant imaged by Optos(®) versus the Heidelberg Spectralis(®) superiorly was 32,373 vs 32,789 pixels, respectively (P = 0.91), inferiorly was 24,665 vs 26,117 pixels, respectively (P = 0.71), temporally was 47,948 vs 20,645 pixels, respectively (P = 0.0001), and nasally was 46,374 vs 22,234 pixels, respectively (P = 0.0001). The Heidelberg Spectralis(®) was able to image the superior and inferior retinal vasculature to a more distal point than was the Optos(®), in nine of ten eyes (18 of 20 quadrants). The Optos(®) was able to image the nasal and temporal retinal vasculature to a more distal point than was the Heidelberg Spectralis(®), in ten of ten eyes (20 of 20 quadrants). The ultra-widefield fluorescein angiography obtained with the Optos(®) and Heidelberg Spectralis(®) ultra-widefield imaging systems are both excellent modalities that provide views of the peripheral retina. On a single nonsteered image, the Optos(®) Optomap(®) covered a significantly larger total retinal surface area, with greater image variability, than did the Heidelberg Spectralis(®) ultra-widefield module. The Optos(®) captured an appreciably wider view of the retina temporally and nasally, albeit with peripheral distortion, while the ultra-widefield Heidelberg Spectralis(®) module was able to image the superior and inferior retinal vasculature more peripherally. The clinical significance of these findings as well as the area imaged on steered montaged images remains to be determined.

  14. Acoustic characteristics of a large-scale wind tunnel model of an upper-surface blown flap transport having two engines

    NASA Technical Reports Server (NTRS)

    Falarski, M. D.; Aoyagi, K.; Koenig, D. G.

    1973-01-01

    The upper-surface blown (USB) flap as a powered-lift concept has evolved because of the potential acoustic shielding provided when turbofan engines are installed on a wing upper surface. The results from a wind tunnel investigation of a large-scale USB model powered by two JT15D-1 turbofan engines are-presented. The effects of coanda flap extent and deflection, forward speed, and exhaust nozzle configuration were investigated. To determine the wing shielding the acoustics of a single engine nacelle removed from the model were also measured. Effective shielding occurred in the aft underwing quadrant. In the forward quadrant the shielding of the high frequency noise was counteracted by an increase in the lower frequency wing-exhaust interaction noise. The fuselage provided shielding of the opposite engine noise such that the difference between single and double engine operation was 1.5 PNdB under the wing. The effects of coanda flap deflection and extent, angle of attack, and forward speed were small. Forward speed reduced the perceived noise level (PNL) by reducing the wing-exhaust interaction noise.

  15. Turbulent pipe flows subjected to temporal decelerations

    NASA Astrophysics Data System (ADS)

    Jeong, Wongwan; Lee, Jae Hwa

    2016-11-01

    Direct numerical simulations of temporally decelerating turbulent pipe flows were performed to examine effects of temporal decelerations on turbulence. The simulations were started with a fully developed turbulent pipe flow at a Reynolds number, ReD =24380, based on the pipe radius (R) and the laminar centerline velocity (Uc 0). Three different temporal decelerations were imposed to the initial flow with f= | d Ub / dt | =0.00127, 0.00625 and 0.025, where Ub is the bulk mean velocity. Comparison of Reynolds stresses and turbulent production terms with those for steady flow at a similar Reynolds number showed that turbulence is highly intensified with increasing f due to delay effects. Furthermore, inspection of the Reynolds shear stress profiles showed that strong second- and fourth-quadrant Reynolds shear stresses are greatly increased, while first- and third-quadrant components are also increased. Decomposition of streamwise Reynolds normal stress with streamwise cutoff wavelength (λx) 1 R revealed that the turbulence delay is dominantly originated from delay of strong large-scale turbulent structures in the outer layer, although small-scale motions throughout the wall layer adjusted more rapidly to the temporal decelerations. This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (NRF-2014R1A1A2057031).

  16. Full Robotic Colorectal Resections for Cancer Combined With Other Major Surgical Procedures: Early Experience With the da Vinci Xi.

    PubMed

    Morelli, Luca; Di Franco, Gregorio; Guadagni, Simone; Palmeri, Matteo; Gianardi, Desirée; Bianchini, Matteo; Moglia, Andrea; Ferrari, Vincenzo; Caprili, Giovanni; D'Isidoro, Cristiano; Melfi, Franca; Di Candio, Giulio; Mosca, Franco

    2017-08-01

    The da Vinci Xi has been developed to overcome some of the limitations of the previous platform, thereby increasing the acceptance of its use in robotic multiorgan surgery. Between January 2015 and October 2015, 10 patients with synchronous tumors of the colorectum and others abdominal organs underwent robotic combined resections with the da Vinci Xi. Trocar positions respected the Universal Port Placement Guidelines provided by Intuitive Surgical for "left lower quadrant," with trocars centered on the umbilical area, or shifted 2 to 3 cm to the right or to the left, depending on the type of combined surgical procedure. All procedures were completed with the full robotic technique. Simultaneous procedures in same quadrant or left quadrant and pelvis, or left/right and upper, were performed with a single docking/single targeting approach; in cases of left/right quadrant or right quadrant/pelvis, we performed a dual-targeting operation. No external collisions or problems related to trocar positions were noted. No patient experienced postoperative surgical complications and the mean hospital stay was 6 days. The high success rate of full robotic colorectal resection combined with other surgical interventions for synchronous tumors, suggest the efficacy of the da Vinci Xi in this setting.

  17. Temporal characteristics of coherent flow structures generated over alluvial sand dunes, Mississippi River, revealed by acoustic doppler current profiling and multibeam echo sounding

    USGS Publications Warehouse

    Czuba, John A.; Oberg, Kevin A.; Best, Jim L.; Parsons, Daniel R.; Simmons, S. M.; Johnson, K.K.; Malzone, C.

    2009-01-01

    This paper investigates the flow in the lee of a large sand dune located at the confluence of the Mississippi and Missouri Rivers, USA. Stationary profiles collected from an anchored boat using an acoustic Doppler current profiler (ADCP) were georeferenced with data from a real-time kinematic differential global positioning system. A multibeam echo sounder was used to map the bathymetry of the confluence and provided a morphological context for the ADCP measurements. The flow in the lee of a low-angle dune shows good correspondence with current conceptual models of flow over dunes. As expected, quadrant 2 events (upwellings of low-momentum fluid) are associated with high backscatter intensity. Turbulent events generated in the lower lee of a dune near the bed are associated with periods of vortex shedding and wake flapping. Remnant coherent structures that advect over the lower lee of the dune in the upper portion of the water column, have mostly dissipated and contribute little to turbulence intensities. The turbulent events that occupy most of the water column in the upper lee of the dune are associated with periods of wake flapping.

  18. Comparison of gonioscopy and anterior segment ocular coherence tomography in detecting angle closure in different quadrants of the anterior chamber angle.

    PubMed

    Sakata, Lisandro M; Lavanya, Raghavan; Friedman, David S; Aung, Han T; Gao, Hong; Kumar, Rajesh S; Foster, Paul J; Aung, Tin

    2008-05-01

    To compare the performance of gonioscopy and anterior segment (AS) optical coherence tomography (OCT) in detecting angle closure in the different quadrants of the anterior chamber angle (ACA). Cross-sectional observational study. Five hundred two consecutive subjects more than 50 years of age with no previous ophthalmic problems recruited from a community clinic in Singapore. All subjects underwent gonioscopy and AS OCT imaging in the dark. Using gonioscopy, the ACA was graded using the Scheie system by a single examiner masked to AS OCT findings. The ACA in a particular quadrant was classified as closed if the posterior trabecular meshwork could not be seen on gonioscopy. A closed ACA on AS OCT imaging was defined by the presence of any contact between the iris and angle wall anterior to the scleral spur. After excluding eyes with poor image quality, a total of 423 right eyes were included in the analysis. A closed angle in at least 1 quadrant was observed in 59% of the eyes by AS OCT and in 33% of the eyes by gonioscopy (P<0.001), with fair agreement between the two methods (kappa = 0.40). The frequency of closed angles by AS OCT and gonioscopy were 48% versus 29% superiorly, 43% versus 22% inferiorly, 18% versus 14% nasally, and 12% versus 20% temporally, respectively. Of the 119 of 1692 quadrants that were closed on gonioscopy but open on AS OCT, a steep iris profile was present in 61 (51%) of 119 quadrants on AS OCT, and of the 276 of 1692 quadrants that were open on gonioscopy but closed on AS OCT, 196 (71%) of 276 quadrants showed short iridoangle contact on AS OCT. The highest rates of closed angles on gonioscopy and AS OCT images were observed in the superior quadrant. Anterior segment OCT tended to detect more closed ACAs than gonioscopy, particularly in the superior and inferior quadrants. Variations in the iris profile and level of iridoangle contact also may explain some of the differences seen between gonioscopy and AS OCT.

  19. A Comparative Evaluation of Adherence of Microorganism to Different Types of Brackets: A Scanning Electron Microscopic Study.

    PubMed

    Shashidhar, E P; Sahitya, M; Sunil, T; Murthy, Anup R; Rani, M S

    2015-09-01

    The purpose of this study was to evaluate and compare the adherence of microorganism to different types of brackets using the scanning electron microscope (SEM). A double-blinded study was undertaken to evaluate and adherence of microorganisms to different types of brackets using SEM. At random, 12 patients reporting for treatment to the department of Orthodontics VS Dental College and Hospital were selected. Four types of brackets were included in the present study stainless steel, titanium, composite, and ceramic. Brackets were bonded to teeth of the patient on all the four quadrants. The teeth included for bonding were lateral incisor, canine, first premolar, and second premolar. The brackets were left for 72 h. After 72 h brackets were debonded, and they were evaluated by SEM for adherence of microorganism in the slot and tie wings surface. The SEM images were graded, and the adherence of microorganism to the brackets in the surfaces and the four different quadrants were recorded. There is a significant difference in adherence of microorganisms to the various types of brackets (P < 0.001) and the surfaces (P < 0.05) included in the study. However, there is no significance in the mean adherence of microorganisms in the different quadrants (P > 0.05) included in the study. The interaction of bracket/surface, bracket/quadrant, surface/quadrants was analyzed, there was no significance of comparison of bracket/surfaces/quadrant but the interaction of bracket/quadrant was found to be significant (<0.011). The interaction of bracket/surfaces/quadrant was also found to be significant (<0.003). The maximum adherence of microorganisms was observed with the composite bracket material and the least adherence of microorganisms was observed with the titanium bracket material. The adherence of microorganisms is relatively more in the slot area, when compare to the tie wings surface maximum adherence of microorganism is observed in the upper left quadrant and least adherence of microorganism is observed in the lower right quadrant. There is a significant difference in adherence of microorganisms to various types of brackets and the surfaces included in the study. There is no significant difference in the adherence of microorganism to the bracket surfaces in the four quadrants included in the study.

  20. A Comparative Evaluation of Adherence of Microorganism to Different Types of Brackets: A Scanning Electron Microscopic Study

    PubMed Central

    Shashidhar, E P; Sahitya, M; Sunil, T; Murthy, Anup R; Rani, M S

    2015-01-01

    Background: The purpose of this study was to evaluate and compare the adherence of microorganism to different types of brackets using the scanning electron microscope (SEM). A double-blinded study was undertaken to evaluate and adherence of microorganisms to different types of brackets using SEM. Materials and Methods: At random, 12 patients reporting for treatment to the department of Orthodontics VS Dental College and Hospital were selected. Four types of brackets were included in the present study stainless steel, titanium, composite, and ceramic. Brackets were bonded to teeth of the patient on all the four quadrants. The teeth included for bonding were lateral incisor, canine, first premolar, and second premolar. The brackets were left for 72 h. After 72 h brackets were debonded, and they were evaluated by SEM for adherence of microorganism in the slot and tie wings surface. The SEM images were graded, and the adherence of microorganism to the brackets in the surfaces and the four different quadrants were recorded. Results: There is a significant difference in adherence of microorganisms to the various types of brackets (P < 0.001) and the surfaces (P < 0.05) included in the study. However, there is no significance in the mean adherence of microorganisms in the different quadrants (P > 0.05) included in the study. The interaction of bracket/surface, bracket/quadrant, surface/quadrants was analyzed, there was no significance of comparison of bracket/surfaces/quadrant but the interaction of bracket/quadrant was found to be significant (<0.011). The interaction of bracket/surfaces/quadrant was also found to be significant (<0.003). Conclusion: The maximum adherence of microorganisms was observed with the composite bracket material and the least adherence of microorganisms was observed with the titanium bracket material. The adherence of microorganisms is relatively more in the slot area, when compare to the tie wings surface maximum adherence of microorganism is observed in the upper left quadrant and least adherence of microorganism is observed in the lower right quadrant. There is a significant difference in adherence of microorganisms to various types of brackets and the surfaces included in the study. There is no significant difference in the adherence of microorganism to the bracket surfaces in the four quadrants included in the study. PMID:26435612

  1. Motor fiber organization in the extratemporal trunk of the facial nerve in rats: A retrograde Fluoro-Gold study

    PubMed Central

    CHEN, LIJIE; HU, MIN; ZHANG, LIHAI; LIU, SANXIA; LUO, JINCHAO; DENG, TIANZHENG; TAO, YE

    2012-01-01

    Understanding the microanatomy of the facial nerve is vital to functional restoration of facial nerve injury. This study aimed to locate the spatial orientation of five branches in the extratemporal trunk of the rat facial nerve (ETFN). Fifteen adult Sprague-Dawley albino rats were divided randomly into five groups corresponding to the five facial nerves. Fluoro-Gold™ (FG) was applied to one branch in all three rats in each group. The trunk of the facial nerve was cut at three points for fluorescence detection. Staining results showed that each branch of the facial motor nerve had a topographical orientation in the distal part of the ETFN. The temporal branch was located in the medial and acroscopic quadrant of the nerve trunk. The zygomatic branch was located in the lateral and acroscopic quadrant. The buccal branch occupied the upper half of the nerve trunk, whereas the mandibular branch occupied the lower half. The cervical branch presented a square-shaped distribution in the lateral nerve trunk. In the middle part of the ETFN, the topographical orientation remained clear, but the FG-labeled zone was extended to some extent. In the stylomastoid foramen region, all branches diffused, thereby blurring the orientation. In conclusion, each branch of the facial motor nerve had a topographical orientation and distribution in the crotch and middle part of the ETFN, but the branches diffused near the stylomastoid foramen. PMID:23226737

  2. Comparison of ultra-widefield fluorescein angiography with the Heidelberg Spectralis® noncontact ultra-widefield module versus the Optos® Optomap®

    PubMed Central

    Witmer, Matthew T; Parlitsis, George; Patel, Sarju; Kiss, Szilárd

    2013-01-01

    Purpose To compare ultra-widefield fluorescein angiography imaging using the Optos® Optomap® and the Heidelberg Spectralis® noncontact ultra-widefield module. Methods Five patients (ten eyes) underwent ultra-widefield fluorescein angiography using the Optos® panoramic P200Tx imaging system and the noncontact ultra-widefield module in the Heidelberg Spectralis® HRA+OCT system. The images were obtained as a single, nonsteered shot centered on the macula. The area of imaged retina was outlined and quantified using Adobe® Photoshop® C5 software. The total area and area within each of four visualized quadrants was calculated and compared between the two imaging modalities. Three masked reviewers also evaluated each quadrant per eye (40 total quadrants) to determine which modality imaged the retinal vasculature most peripherally. Results Optos® imaging captured a total retinal area averaging 151,362 pixels, ranging from 116,998 to 205,833 pixels, while the area captured using the Heidelberg Spectralis® was 101,786 pixels, ranging from 73,424 to 116,319 (P = 0.0002). The average area per individual quadrant imaged by Optos® versus the Heidelberg Spectralis® superiorly was 32,373 vs 32,789 pixels, respectively (P = 0.91), inferiorly was 24,665 vs 26,117 pixels, respectively (P = 0.71), temporally was 47,948 vs 20,645 pixels, respectively (P = 0.0001), and nasally was 46,374 vs 22,234 pixels, respectively (P = 0.0001). The Heidelberg Spectralis® was able to image the superior and inferior retinal vasculature to a more distal point than was the Optos®, in nine of ten eyes (18 of 20 quadrants). The Optos® was able to image the nasal and temporal retinal vasculature to a more distal point than was the Heidelberg Spectralis®, in ten of ten eyes (20 of 20 quadrants). Conclusion The ultra-widefield fluorescein angiography obtained with the Optos® and Heidelberg Spectralis® ultra-widefield imaging systems are both excellent modalities that provide views of the peripheral retina. On a single nonsteered image, the Optos® Optomap® covered a significantly larger total retinal surface area, with greater image variability, than did the Heidelberg Spectralis® ultra-widefield module. The Optos® captured an appreciably wider view of the retina temporally and nasally, albeit with peripheral distortion, while the ultra-widefield Heidelberg Spectralis® module was able to image the superior and inferior retinal vasculature more peripherally. The clinical significance of these findings as well as the area imaged on steered montaged images remains to be determined. PMID:23458976

  3. Characterizing the Propagation of Uterine Electrophysiological Signals Recorded with a Multi-Sensor Abdominal Array in Term Pregnancies.

    PubMed

    Escalona-Vargas, Diana; Govindan, Rathinaswamy B; Furdea, Adrian; Murphy, Pam; Lowery, Curtis L; Eswaran, Hari

    2015-01-01

    The objective of this study was to quantify the number of segments that have contractile activity and determine the propagation speed from uterine electrophysiological signals recorded over the abdomen. The uterine magnetomyographic (MMG) signals were recorded with a 151 channel SARA (SQUID Array for Reproductive Assessment) system from 36 pregnant women between 37 and 40 weeks of gestational age. The MMG signals were scored and segments were classified based on presence of uterine contractile burst activity. The sensor space was then split into four quadrants and in each quadrant signal strength at each sample was calculated using center-of-gravity (COG). To this end, the cross-correlation analysis of the COG was performed to calculate the delay between pairwise combinations of quadrants. The relationship in propagation across the quadrants was quantified and propagation speeds were calculated from the delays. MMG recordings were successfully processed from 25 subjects and the average values of propagation speeds ranged from 1.3-9.5 cm/s, which was within the physiological range. The propagation was observed between both vertical and horizontal quadrants confirming multidirectional propagation. After the multiple pairwise test (99% CI), significant differences in speeds can be observed between certain vertical or horizontal combinations and the crossed pair combinations. The number of segments containing contractile activity in any given quadrant pair with a detectable delay was significantly higher in the lower abdominal pairwise combination as compared to all others. The quadrant-based approach using MMG signals provided us with high spatial-temporal information of the uterine contractile activity and will help us in the future to optimize abdominal electromyographic (EMG) recordings that are practical in a clinical setting.

  4. Characterizing the Propagation of Uterine Electrophysiological Signals Recorded with a Multi-Sensor Abdominal Array in Term Pregnancies

    PubMed Central

    Escalona-Vargas, Diana; Govindan, Rathinaswamy B.; Furdea, Adrian; Murphy, Pam; Lowery, Curtis L.; Eswaran, Hari

    2015-01-01

    The objective of this study was to quantify the number of segments that have contractile activity and determine the propagation speed from uterine electrophysiological signals recorded over the abdomen. The uterine magnetomyographic (MMG) signals were recorded with a 151 channel SARA (SQUID Array for Reproductive Assessment) system from 36 pregnant women between 37 and 40 weeks of gestational age. The MMG signals were scored and segments were classified based on presence of uterine contractile burst activity. The sensor space was then split into four quadrants and in each quadrant signal strength at each sample was calculated using center-of-gravity (COG). To this end, the cross-correlation analysis of the COG was performed to calculate the delay between pairwise combinations of quadrants. The relationship in propagation across the quadrants was quantified and propagation speeds were calculated from the delays. MMG recordings were successfully processed from 25 subjects and the average values of propagation speeds ranged from 1.3–9.5 cm/s, which was within the physiological range. The propagation was observed between both vertical and horizontal quadrants confirming multidirectional propagation. After the multiple pairwise test (99% CI), significant differences in speeds can be observed between certain vertical or horizontal combinations and the crossed pair combinations. The number of segments containing contractile activity in any given quadrant pair with a detectable delay was significantly higher in the lower abdominal pairwise combination as compared to all others. The quadrant-based approach using MMG signals provided us with high spatial-temporal information of the uterine contractile activity and will help us in the future to optimize abdominal electromyographic (EMG) recordings that are practical in a clinical setting. PMID:26505624

  5. Where Does the Transplanted Fat is Located in the Gluteal Region? Research Letter.

    PubMed

    Ramos-Gallardo, Guillermo; Medina-Zamora, Pablo; Cardenas-Camarena, Lázaro; Orozco-Rentería, David; Duran-Vega, Héctor; Mota-Fonseca, Eduardo

    2017-12-29

    Liposuction is one of the most popular plastic surgery procedures. As in any surgery, there are risks and complications, especially when combined with fat injection. Case reports of fat embolism have been reported. A possible explanation is the puncture and tearing of gluteal vessels during the procedure, especially when a deep injection is planned. To identify the places where fat can be located after injection during a fat graft in the gluteus. An experimental study was done in which colorant was injected in four directions using four different quadrants of the gluteus. We Injected 10 cc six times following clock hands until 60 cc were injected, and the cutaneous flap and the muscles were then elevated. Our main purpose was to describe where the colorant went and if it was in contact with the vessels (superior and inferior gluteal vessels). In total, four gluteus muscles were injected and dissected. Injection in the lower lateral quadrant was mainly into the muscle, and colorant was observed in the hypogastric vessels. The injection in the upper quadrants stayed mainly in the subcutaneous tissue. During surgery, it is important to identify the location of the perforators and to avoid a deep injection, especially from the lower lateral quadrant to the superior medial quadrant (Q4 to Q1), as the probability of puncturing and injecting fat into the main vessels from this direction is higher.

  6. Microphysical Structures of Hurricane Irma Observed by Polarimetric Radar

    NASA Astrophysics Data System (ADS)

    Didlake, A. C.; Kumjian, M. R.

    2017-12-01

    This study examines dual-polarization radar observations of Hurricane Irma as its center passed near the WSR-88D radar in Puerto Rico, capturing needed microphysical information of a mature tropical cyclone. Twenty hours of observations continuously sampled the inner core precipitation features. These data were analyzed by annuli and azimuth, providing a bulk characterization of the primary eyewall, secondary eyewall, and rainbands as they varied around the storm. Polarimetric radar variables displayed distinct signatures of convective and stratiform precipitation in the primary eyewall and rainbands that were organized in a manner consistent with the expected kinematic asymmetry of a storm in weak environmental wind shear but with moderate low-level storm-relative flow. In the front quadrants of the primary eyewall, vertical profiles of differential reflectivity (ZDR) exhibit increasing values with decreasing height consistent with convective precipitation processes. In particular, the front-right quadrant exhibits a signature in reflectivity (ZH) and ZDR indicating larger, sparser drops, which is consistent with a stronger updraft present in this quadrant. In the rear quadrants, a sharply peaked ZDR maximum occurs within the melting layer, which is attributed of stratiform processes. In the rainbands, the convective to stratiform transition can be seen traveling from the front-right to the front-left quadrant. The front-right quadrant exhibits lower co-polar correlation coefficient (ρHV) values in the 3-8 km altitude layer, suggesting larger vertical spreading of various hydrometeors that occurs in convective vertical motions. The front-left quadrant exhibits larger ρHV values, suggesting less diversity of hydrometeor shapes, consistent with stratiform processes. The secondary eyewall did not exhibit a clear signature of processes preferred in a specific quadrant, and a temporal analysis of the secondary eyewall revealed a complex evolution of its structure. These results provide important microphysical insight that are critical for understanding the inner core processes modulating tropical cyclone intensity and structure.

  7. Meta-analysis of stratus OCT glaucoma diagnostic accuracy.

    PubMed

    Chen, Hsin-Yi; Chang, Yue-Cune

    2014-09-01

    To evaluate the diagnostic accuracy of glaucoma in different stages, different types of glaucoma, and different ethnic groups using Stratus optical coherence tomography (OCT). We searched MEDLINE to identify available articles on diagnostic accuracy of glaucoma published between January 2004 and December 2011. A PubMed (National Center for Biotechnology Information) search using medical subject headings and keywords was executed using the following terms: "diagnostic accuracy" or "receiver operator characteristic" or "area under curve" or "AUC" and "Stratus OCT" and "glaucoma." The search was subsequently limited to publications in English. The area under a receiver operator characteristic (AUC) curve was used to measure the diagnostic performance. A random-effects model was used to estimate the pooled AUC value of the 17 parameters (average retinal nerve fiber layer thickness, temporal quadrant, superior quadrant, nasal quadrant, inferior quadrant, and 1 to 12 o'clock). Meta-regression analysis was used to check the significance of some important factors: (1) glaucoma severity (five stages), (2) glaucoma types (four types), and (3) ethnicity (four categories). The orders of accuracy among those parameters were as follows: average > inferior > superior > 7 o'clock > 6 o'clock > 11 o'clock > 12 o'clock > 1 o'clock > 5 o'clock > nasal > temporal > 2 o'clock > 10 o'clock > 8 o'clock > 9 o'clock > 4 o'clock > 3 o'clock. After adjusting for the effects of age, glaucoma severity, glaucoma types, and ethnicity, the average retinal nerve fiber layer thickness provided highest accuracy compared with the other parameters of OCT. The diagnostic accuracy in Asian populations was significantly lower than that in whites and the other two ethnic types. Stratus OCT demonstrated good diagnostic capability in differentiating glaucomatous from normal eyes. However, we should be more cautious in applying this instrument in Asian groups in glaucoma management.

  8. The relationship between sitting posture and seated-related upper quadrant musculoskeletal pain in computing South African adolescents: A prospective study.

    PubMed

    Brink, Yolandi; Louw, Quinette; Grimmer, Karen; Jordaan, Esmè

    2015-12-01

    There is evidence that consistent sitting for prolonged periods is associated with upper quadrant musculoskeletal pain (UQMP). It is unclear whether postural alignment is a significant risk factor. The aim of the prospective study (2010-2011) was to ascertain if three-dimensional sitting postural angles, measured in a real-life school computer classroom setting, predict seated-related UQMP. Asymptomatic Grade 10 high-school students, aged 15-17 years, undertaking Computer Application Technology, were eligible to participate. Using the 3D Posture Analysis Tool, sitting posture was measured while students used desk-top computers. Posture was reported as five upper quadrant angles (Head flexion, Neck flexion; Craniocervical angle, Trunk flexion and Head lateral bending). The Computer Usage Questionnaire measured seated-related UQMP and hours of computer use. The Beck Depression Inventory and the Multidimensional Anxiety Scale for Children assessed psychosocial factors. Sitting posture, computer use and psychosocial factors were measured at baseline. UQMP was measured at six months and one-year follow-up. 211, 190 and 153 students participated at baseline, six months and one-year follow-up respectively. 34.2% students complained of seated-related UQMP during the follow-up period. Increased head flexion (HF) predicted seated-related UQMP developing over time for a small group of students with pain scores greater than the 90th pain percentile, adjusted for age, gender, BMI, computer use and psychosocial factors (p = 0.003). The pain score increased 0.22 points per 1° increase in HF. Classroom ergonomics and postural hygiene should therefore focus on reducing large HF angles among computing adolescents. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Psychosocial factors and shoulder symptom development among workers.

    PubMed

    Smith, Caroline K; Silverstein, Barbara A; Fan, Z Joyce; Bao, Stephen; Johnson, Peter W

    2009-01-01

    Shoulder injuries are a common cause of pain and discomfort. Many work-related factors have been associated with the onset of shoulder symptoms. The psychosocial concepts in the demand-control model have been studied in association with musculoskeletal symptoms but with heterogeneous findings. The purpose of this study was to assess the relationship between the psychosocial concepts of the demand-control model and the incidence of shoulder symptoms in a working population. After following 424 subjects for approximately 1 year, 85 incident cases were identified from self-reported data. Cox proportional hazards modeling was used to assess the associations between shoulder symptoms and demand-control model quadrants. Cases were more likely to be female and report other upper extremity symptoms at baseline (P < 0.05). From the hazard models, being in either a passive or high strain job quadrant was associated with the incidence of shoulder symptoms. Hazard ratios were 2.17, 95% CI 1.02-4.66 and 2.19, 95% CI 1.08-4.42, respectively. Using self-reporting to determine demand-control quadrants was successful in identifying subjects at risk of developing work-related shoulder symptoms. Research is needed to determine if this relationship holds with clinically diagnosed shoulder and other upper extremity musculoskeletal disorders. This may be part of a simple tool for assessing risk of developing these UEMSDs. (c) 2008 Wiley-Liss, Inc.

  10. Tokyo, Yokohama and Tokoy Bay as seen from STS-58

    NASA Technical Reports Server (NTRS)

    1993-01-01

    Japan's modern megalopolis is seen in this nadir view in great detail. More than 80 vessels can be seen at the anchorage's in Tokyo Bay. The gardens of the Emperor's Palace are seen in this circular area in the upper left quadrant.

  11. Primary actinomycosis of the breast caused by Actinomyces turicensis with associated Peptoniphilus harei.

    PubMed

    Abdulrahman, Ganiy Opeyemi; Gateley, Christopher Alan

    2015-01-01

    Actinomycosis of the breast is a rare disease which may mimic malignancy in presentation. Clinical presentation may make it difficult to distinguish primary actinomycosis from mastitis and inflammatory carcinoma. A 22-year-old lady presented with a 3-week history of right breast pain and greenish discharge through her nipple piercing. Physical examination revealed a palpable fluctuant lump in the upper inner quadrant of the right breast and a nipple jewelry in-situ in the upper inner quadrant of the right breast with an abscess at the edge of the areola. Needle aspiration was performed and microbiological examination of the aspirate isolated Actinomyces turicensis and Peptoniphilus harei. Actinomycosis of the breast is rare and the specie, Actinomyces turicensis, is even rarer especially in association with Peptoniphilus harei. Actinomyces is a difficult organism to treat due to its relative indolent course with potential scarring and disruption of local tissue. However, surgical intervention could be avoided with an intensive course of high-dose intravenous antibiotics and prolonged oral antibiotics afterwards.

  12. Optimal Coordinated EV Charging with Reactive Power Support in Constrained Distribution Grids

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

    Paudyal, Sumit; Ceylan, Oğuzhan; Bhattarai, Bishnu P.

    Electric vehicle (EV) charging/discharging can take place in any P-Q quadrants, which means EVs could support reactive power to the grid while charging the battery. In controlled charging schemes, distribution system operator (DSO) coordinates with the charging of EV fleets to ensure grid’s operating constraints are not violated. In fact, this refers to DSO setting upper bounds on power limits for EV charging. In this work, we demonstrate that if EVs inject reactive power into the grid while charging, DSO could issue higher upper bounds on the active power limits for the EVs for the same set of grid constraints.more » We demonstrate the concept in an 33-node test feeder with 1,500 EVs. Case studies show that in constrained distribution grids in coordinated charging, average costs of EV charging could be reduced if the charging takes place in the fourth P-Q quadrant compared to charging with unity power factor.« less

  13. Visuotopic organization of the cebus pulvinar: a double representation the contralateral hemifield.

    PubMed

    Gattass, R; Oswaldo-Cruz, E; Sousa, A P

    1978-08-18

    The projection of the visual field in the pulvinar nucleus was studied in 17 Cebus monkeys using electrophysiological techniques. Visual space is represented in two regions of the pulvinar; (1) the ventrolateral group, Pvlg, comprising nuclei P delta, P delta, P gamma, P eta and P mu 1; and (2) P mu. In the first group, which corresponds to the pulvinar inferior and ventral part of the pulvinar lateralis, we observed a greater respresentation of the central part of the visual field. Approximately 58% of the volume of the ventrolateral group is concerned with the visual space within 10 degrees of the fovea. This portion of the visual field is represented at its lateral aspects, mainly close to the level of the caudal pole of the lateral geniculate nucleus (LGN). Projection of the vertical meridian runs along its lateral border while that of the horizontal one is found running from the dorsal third of the LGN's hilus to the medial border of the ventro-lateral group. The lower quadrant is represented at its dorsal portion while the upper quadrant is represented at the ventral one. In Pmu the representation is rotated 90 degrees clockwise around the rostrocaudal axis: the vertical meridian is found at the ventromedial border of this nucleus. Thus, the lower quadrant is represented at the later portion of Pmu and the upper at its medial portion. Both projections are restricted to the contralateral hemifield.

  14. The utility of clinical findings to predict laboratory values in hypertensive disorders of pregnancy.

    PubMed

    So, Jane; Young, Elizabeth; Crnosija, Natalie; Chappelle, Joseph

    2016-04-01

    Preeclampsia is the 2nd leading cause of maternal mortality in the United States. Women with new-onset or worsening hypertension are commonly evaluated for laboratory abnormalities. We aim to investigate whether demographic and/or clinical findings correlate with abnormal laboratory values. A retrospective chart review of women who presented for evaluation of hypertension in pregnancy during 2010. Demographic information, medical history, symptoms, vital signs, and laboratory results were collected. Bivariate analysis was used to investigate associations between predictors and the outcome. Of the 481 women in the sample, 22 were identified as having abnormal laboratory test results (4.6%). Women who reported right upper quadrant pain or tenderness had significantly increased likelihood of having laboratory abnormalities compared to those without the complaint. Only a small percentage of women evaluated were determined to have abnormal laboratory findings, predominantly among women with severe preeclampsia. Right upper quadrant pain or tenderness was positively correlated with laboratory abnormalities. The restriction of laboratory analysis in women with clinical evidence of severe disease may be warranted - a broader study should, however, first be used to confirm our findings.

  15. Splenic infarction in a patient hereditary spherocytosis, protein C deficiency and acute infectious mononucleosis.

    PubMed

    Breuer, Christian; Janssen, Gisela; Laws, Hans-Jürgen; Schaper, Jörg; Mayatepek, Ertan; Schroten, Horst; Tenenbaum, Tobias

    2008-12-01

    Splenic infarction is a common cause of left upper quadrant pain and must be suspected in patients with hematologic or thromboembolic conditions and signs of localized or systemic inflammation. Although several mechanisms have been proposed for splenic infarction in patients with various hematologic disorders, hereditary spherocytosis (HS) is usually not associated with an increased risk for thromboembolic events. We report a 13-year-old male with HS who was referred to our hospital with a 4-day history of fever and left upper quadrant pain. Ultrasound scans and magnetic resonance imaging showed lesions suggestive of splenic infarction. Initially, antibiotic treatment was started because secondary infection was suspected. However, 1 week after admission the patient developed typical clinical signs of acute infectious mononucleosis. Further laboratory work up confirmed the diagnosis of acute Epstein-Barr virus infection and additionally revealed protein C deficiency. This association has not been reported previously and may have contributed to the development of splenic infarction. Since infectious mononucleosis is a common cause for clinical consultations in adolescence, physicians caring for children with hematologic disorders should be particularly aware of those possible complications.

  16. US-guided percutaneous cholecystostomy: features predicting culture-positive bile and clinical outcome.

    PubMed

    Sosna, Jacob; Kruskal, Jonathan B; Copel, Laurian; Goldberg, S Nahum; Kane, Robert A

    2004-03-01

    To assess sonographic and clinical features that might be used to predict infected bile and/or patient outcome from ultrasonography (US)-guided percutaneous cholecystostomy. Between February 1997 and August 2002 at one institution, 112 patients underwent US-guided percutaneous cholecystostomy (59 men, 53 women; average age, 69.3 years). All US images were scored on a defined semiquantitative scale according to preset parameters: (a) gallbladder distention, (b) sludge and/or stones, (c) wall appearance, (d) pericholecystic fluid, and (e) common bile duct size and/or choledocholithiasis. Separate and total scores were generated. Retrospective evaluation of (a) the bacteriologic growth of aspirated bile and its color and (b) clinical indices (fever, white blood cell count, bilirubin level, liver function test results) was conducted by reviewing medical records. For each patient, the clinical manifestation was classified into four groups: (a) localized right upper quadrant symptoms, (b) generalized abdominal symptoms, (c) unexplained sepsis, or (d) sepsis with other known infection. Logistic regression models, exact Wilcoxon-Mann-Whitney test, and the Kruskal-Wallis test were used. Forty-seven (44%) of 107 patients had infected bile. A logistic regression model showed that wall appearance, distention, bile color, and pericholecystic fluid were not individually significant predictors for culture-positive bile, leaving sludge and/or stones (P =.003, odds ratio = 1.647), common bile duct status (P =.02, odds ratio = 2.214), and total score (P =.007, odds ratio = 1.267). No US covariates or clinical indices predicted clinical outcome. Clinical manifestation was predictive of clinical outcome (P =.001) and aspirating culture-positive bile (P =.008); specifically, 30 (86%) of 35 patients with right upper quadrant symptoms had their condition improve, compared with one (7%) of 15 asymptomatic patients with other known causes of infection. US variables can be used to predict culture-positive bile but not patient outcome. Clinical manifestation is important because patients with right upper quadrant symptoms have the best clinical outcome. Copyright RSNA, 2004

  17. Spatial limitations of fast temporal segmentation are best modeled by V1 receptive fields.

    PubMed

    Goodbourn, Patrick T; Forte, Jason D

    2013-11-22

    The fine temporal structure of events influences the spatial grouping and segmentation of visual-scene elements. Although adjacent regions flickering asynchronously at high temporal frequencies appear identical, the visual system signals a boundary between them. These "phantom contours" disappear when the gap between regions exceeds a critical value (g(max)). We used g(max) as an index of neuronal receptive-field size to compare with known receptive-field data from along the visual pathway and thus infer the location of the mechanism responsible for fast temporal segmentation. Observers viewed a circular stimulus reversing in luminance contrast at 20 Hz for 500 ms. A gap of constant retinal eccentricity segmented each stimulus quadrant; on each trial, participants identified a target quadrant containing counterphasing inner and outer segments. Through varying the gap width, g(max) was determined at a range of retinal eccentricities. We found that g(max) increased from 0.3° to 0.8° for eccentricities from 2° to 12°. These values correspond to receptive-field diameters of neurons in primary visual cortex that have been reported in single-cell and fMRI studies and are consistent with the spatial limitations of motion detection. In a further experiment, we found that modulation sensitivity depended critically on the length of the contour and could be predicted by a simple model of spatial summation in early cortical neurons. The results suggest that temporal segmentation is achieved by neurons at the earliest cortical stages of visual processing, most likely in primary visual cortex.

  18. Optical coherence tomography in papilledema and pseudopapilledema with and without optic nerve head drusen.

    PubMed

    Bassi, Shikha Talwar; Mohana, Kuppuswamy Parthasarthy

    2014-12-01

    To compare the spectral domain optical coherence tomography (SD-OCT) findings of the optic disc and the peripapillary retina of patients with a true papilledema and pseudopapilledema with and without optic nerve head drusen (ONHD). Retrospective Case Control Study. Peripapillary retinal nerve fiber layer (PPRNFL) thickness as depicted by SD-OCT of 94 eyes of 66 patients with papilledema (30 eyes), pseudopapiledema (31 eyes), and normal controls (33 eyes) was analyzed. The mean RNFL thickness, total retinal thickness (TRT) at a superior and inferior edge of the disc and the quadrant wise topography of increased RNFL were compared in all three groups. Sensitivity, specificity, and area under the receiver operating characteristic curve (AROC) were calculated for all the parameters. The median RNFL thickness was 185.4 (129.5-349.3 μm), 122.3 (109-156.3 μm) and 91.62 ± 7 μm in papilledema, pseudopapilledema, and controls, respectively. Papilledema group had thicker PPRNFL in all quadrants except temporal quadrant. TRT was thicker in papilledema and pseudopapilledema compared to controls. ONHD could be directly visualized as high reflective clumps in the sub-retinal space or the RNFL in 30 eyes. Increased RNFL thickness in all four quadrants was noted 43.3% in papilledema and 9.7% in pseudopapilledema. Normal RNFL thickness in all four quadrants was noted in 0% in papilledema and 32.3% in pseudopapilledema. Nasal RNFL had the highest AROC (0.792) indicating high diagnostic ability to differentiate papilledema from pseudopapilledema. SD-OCT can be used as a tool to differentiate between papilledema and pseudopapilledema.

  19. The radiological features, diagnosis and management of screen-detected lobular neoplasia of the breast: Findings from the Sloane Project.

    PubMed

    Maxwell, Anthony J; Clements, Karen; Dodwell, David J; Evans, Andrew J; Francis, Adele; Hussain, Monuwar; Morris, Julie; Pinder, Sarah E; Sawyer, Elinor J; Thomas, Jeremy; Thompson, Alastair

    2016-06-01

    To investigate the radiological features, diagnosis and management of screen-detected lobular neoplasia (LN) of the breast. 392 women with pure LN alone were identified within the prospective UK cohort study of screen-detected non-invasive breast neoplasia (the Sloane Project). Demography, radiological features and diagnostic and therapeutic procedures were analysed. Non-pleomorphic LN (369/392) was most frequently diagnosed among women aged 50-54 and in 53.5% was at the first screen. It occurred most commonly on the left (58.0%; p = 0.003), in the upper outer quadrant and confined to one site (single quadrant or retroareolar region). No bilateral cases were found. The predominant radiological feature was microcalcification (most commonly granular) which increased in frequency with increasing breast density. Casting microcalcification as a predominant feature had a significantly higher lesion size compared to granular and punctate patterns (p = 0.034). 326/369 (88.3%) women underwent surgery, including 17 who underwent >1 operation, six who had mastectomy and six who had axillary surgery. Two patients had radiotherapy and 15 had endocrine treatment. Pleomorphic lobular carcinoma in situ (23/392) presented as granular microcalcification in 12; four women had mastectomy and six had radiotherapy. Screen-detected LN occurs in relatively young women and is predominantly non-pleomorphic and unilateral. It is typically associated with granular or punctate microcalcification in the left upper outer quadrant. Management, including surgical resection, is highly variable and requires evidence-based guideline development. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Analysis of WindSat Data over Arctic Sea Ice

    USDA-ARS?s Scientific Manuscript database

    The radiation of the 3rd and 4th Stokes components emitted by Arctic sea ice and observed by the spaceborne fully polarimetric radiometer WindSat is investigated. Two types of analysis are carried out, spatial (maps of different quadrants of azimuth look angles) and temporal (time series of daily av...

  1. Turbulent Reynolds stress and quadrant event activity in wind flow over a coastal foredune

    NASA Astrophysics Data System (ADS)

    Chapman, Connie A.; Walker, Ian J.; Hesp, Patrick A.; Bauer, Bernard O.; Davidson-Arnott, Robin G. D.

    2012-05-01

    Recent research on quasi-instantaneous turbulent kinematic Reynolds stresses (RS, - u'w') and decomposed quadrant event activity (e.g., ejections and sweeps) over dunes in fluvial settings and in wind tunnels has shown that turbulent stresses at the toe of a dune often exceed time-averaged, streamwise shear stress (ρ u * 2) estimates. It is believed that semi-coherent turbulent structures are conveyed toward the bed along concave streamlines in this region and that impact of these structures cause fluctuations in local surface stresses that assist in grain entrainment. This has been hypothesized to explain how sand is supplied to the windward slope through a region of flow stagnation. Toward the crest, surface stress increases and becomes dominated by streamwise accelerations resulting from streamline compression and convexity that suppress vertical motions. High-frequency (32 Hz) measurements of turbulent wind flow from 3-D ultrasonic anemometers are analyzed for oblique onshore flow over a vegetated coastal foredune in Prince Edward Island, Canada. Reynolds stress and quadrant activity distributions varied with height (0.60 m and 1.66 m) and location over the dune. In general, quadrant 2 ejection (u' < 0, w' > 0) and quadrant 4 sweep activity (u' > 0, w' < 0) dominated momentum transfer and RS generation over quadrant 1 outward interaction (u' > 0, w' > 0) and quadrant 3 inward interaction (u' < 0, w' < 0) activity. On the lower stoss slope, significant ejection and sweep event activity was most frequent (85 to 92%, ejections plus sweeps), whereas, at the upper crest, significant ejection and sweep activity became less frequent while significant outward and inward interactions increased in frequency (25 to 36%). An 'exuberance effect' (i.e., changing shape of quadrant frequency distribution skewed toward ejection and sweep activity) is observed whereby streamline compression and convexity effects inhibit vertical fluctuations in flow and, thus, reduce the frequency of ejections and sweep activity toward the crest. In separated flow in the lee of the crest, quadrant distributions were more symmetrical as a result of more mixed, multi-directional flow. These trends in turbulent event distributions and Reynolds stress have implications for sediment transport dynamics across the dune and may help to explain sand transport potential and dune maintenance. For example, areas with a high frequency of ejection and sweep activity may have higher rates of sediment entrainment and transport, whereas areas with lower ejection and sweep activity and an increase in outward and inward interactions, which contribute negatively to Reynolds stress generation, may experience a greater potential for deposition. Further research on associations between quadrant event activity and coincident sand transport is required to confirm this hypothesis and the resultant significance of the flow exuberance effect in aeolian dune morphodynamics.

  2. In vivo precision of conventional and digital methods for obtaining quadrant dental impressions.

    PubMed

    Ender, Andreas; Zimmermann, Moritz; Attin, Thomas; Mehl, Albert

    2016-09-01

    Quadrant impressions are commonly used as alternative to full-arch impressions. Digital impression systems provide the ability to take these impressions very quickly; however, few studies have investigated the accuracy of the technique in vivo. The aim of this study is to assess the precision of digital quadrant impressions in vivo in comparison to conventional impression techniques. Impressions were obtained via two conventional (metal full-arch tray, CI, and triple tray, T-Tray) and seven digital impression systems (Lava True Definition Scanner, T-Def; Lava Chairside Oral Scanner, COS; Cadent iTero, ITE; 3Shape Trios, TRI; 3Shape Trios Color, TRC; CEREC Bluecam, Software 4.0, BC4.0; CEREC Bluecam, Software 4.2, BC4.2; and CEREC Omnicam, OC). Impressions were taken three times for each of five subjects (n = 15). The impressions were then superimposed within the test groups. Differences from model surfaces were measured using a normal surface distance method. Precision was calculated using the Perc90_10 value. The values for all test groups were statistically compared. The precision ranged from 18.8 (CI) to 58.5 μm (T-Tray), with the highest precision in the CI, T-Def, BC4.0, TRC, and TRI groups. The deviation pattern varied distinctly depending on the impression method. Impression systems with single-shot capture exhibited greater deviations at the tooth surface whereas high-frame rate impression systems differed more in gingival areas. Triple tray impressions displayed higher local deviation at the occlusal contact areas of upper and lower jaw. Digital quadrant impression methods achieve a level of precision, comparable to conventional impression techniques. However, there are significant differences in terms of absolute values and deviation pattern. With all tested digital impression systems, time efficient capturing of quadrant impressions is possible. The clinical precision of digital quadrant impression models is sufficient to cover a broad variety of restorative indications. Yet the precision differs significantly between the digital impression systems.

  3. Functional and morphological assessment of ocular structures and follow-up of patients with early-stage Parkinson's disease.

    PubMed

    Hasanov, Samir; Demirkilinc Biler, Elif; Acarer, Ahmet; Akkın, Cezmi; Colakoglu, Zafer; Uretmen, Onder

    2018-05-09

    To evaluate and follow-up of functional and morphological changes of the optic nerve and ocular structures prospectively in patients with early-stage Parkinson's disease. Nineteen patients with a diagnosis of early-stage Parkinson's disease and 19 age-matched healthy controls were included in the study. All participants were examined minimum three times at the intervals of at least 6 month following initial examination. Pattern visually evoked potentials (VEP), contrast sensitivity assessments at photopic conditions, color vision tests with Ishihara cards and full-field visual field tests were performed in addition to measurement of retinal nerve fiber layer (RNFL) thickness of four quadrants (top, bottom, nasal, temporal), central and mean macular thickness and macular volumes. Best corrected visual acuity was observed significantly lower in study group within all three examinations. Contrast sensitivity values of the patient group were significantly lower in all spatial frequencies. P100 wave latency of VEP was significantly longer, and amplitude was lower in patient group; however, significant deterioration was not observed during the follow-up. Although average peripapillary RNFL thickness was not significant between groups, RNFL thickness in the upper quadrant was thinner in the patient group. While there was no difference in terms of mean macular thickness and total macular volume values between the groups initially, a significant decrease occurred in the patient group during the follow-up. During the initial and follow-up process, a significant deterioration in visual field was observed in the patient group. Structural and functional disorders shown as electro-physiologically and morphologically exist in different parts of visual pathways in early-stage Parkinson's disease.

  4. Pigmented paravenous chorioretinal atrophy is associated with a mutation within the crumbs homolog 1 (CRB1) gene.

    PubMed

    McKay, Gareth J; Clarke, Stephen; Davis, Jason A; Simpson, David A C; Silvestri, Giuliana

    2005-01-01

    Pigmented paravenous chorioretinal atrophy (PPCRA) is an unusual retinal degeneration characterized by accumulation of pigmentation along retinal veins. The purpose of this study was to describe the phenotype of a family with PPCRA, determine the mode of inheritance, and identify the causal mutation. Ophthalmic examination was performed on seven family members and serially detailed in the proband over a 3-year period. Blood samples were collected and DNA extracted. All 12 coding exons and the 5' promoter region of the crumbs homologue 1 (CRB1) gene were PCR amplified and DNA sequenced. In silico homology modeling was performed on the mutated protein domain. Subtle symmetrical chorioretinal atrophy in the inferior quadrant was the earliest clinical sign detectable within this family. Paravenous pigmentation occurred initially in the far periphery, progressing centrally, with atrophy later becoming more widespread, involving the nasal, then the temporal, and finally the upper quadrant. A novel, dominant Val162Met mutation within the fourth EGF-like domain of CRB1 cosegregates with the PPCRA phenotype. It is thought to affect domain structure, because codon 162 is involved in hydrogen bonding between the antiparallel beta-strands of the major beta-sheet, causing sufficient perturbation of the backbone that the domain-stabilizing hydrogen bond does not form or is weakened. PPCRA was dominantly inherited in this family, but exhibited variable expressivity. Males are more likely to exhibit a severe phenotype, whereas females may remain virtually asymptomatic even in later years. The PPCRA phenotype is associated with a Val162Met mutation in CRB1 which is likely to affect the structure of the CRB1 protein.

  5. Sickle cell hepatopathy.

    PubMed

    Bandyopadhyay, Ranjana; Bandyopadhyay, Sanjay K; Dutta, Anita

    2008-01-01

    Sickle cell hepatopathy is a well-documented entity that ranges from the self-limiting hepatic right upper quadrant syndrome to the potentially lethal intrahepatic cholestasis and acute hepatic sequestration syndromes. We describe a 26-year-male with homozygous sickle cell disease who had this unique hepatic presentation and was documented to have characteristic findings of cholestasis, portal inflammation and sinusoidal dilatation on histopathology.

  6. Remote Evaluation of Rotational Velocity Using a Quadrant Photo-Detector and a DSC Algorithm

    PubMed Central

    Zeng, Xiangkai; Zhu, Zhixiong; Chen, Yang

    2016-01-01

    This paper presents an approach to remotely evaluate the rotational velocity of a measured object by using a quadrant photo-detector and a differential subtraction correlation (DSC) algorithm. The rotational velocity of a rotating object is determined by two temporal-delay numbers at the minima of two DSCs that are derived from the four output signals of the quadrant photo-detector, and the sign of the calculated rotational velocity directly represents the rotational direction. The DSC algorithm does not require any multiplication operations. Experimental calculations were performed to confirm the proposed evaluation method. The calculated rotational velocity, including its amplitude and direction, showed good agreement with the given one, which had an amplitude error of ~0.3%, and had over 1100 times the efficiency of the traditional cross-correlation method in the case of data number N > 4800. The confirmations have shown that the remote evaluation of rotational velocity can be done without any circular division disk, and that it has much fewer error sources, making it simple, accurate and effective for remotely evaluating rotational velocity. PMID:27120607

  7. Spatial Probability Dynamically Modulates Visual Target Detection in Chickens

    PubMed Central

    Sridharan, Devarajan; Ramamurthy, Deepa L.; Knudsen, Eric I.

    2013-01-01

    The natural world contains a rich and ever-changing landscape of sensory information. To survive, an organism must be able to flexibly and rapidly locate the most relevant sources of information at any time. Humans and non-human primates exploit regularities in the spatial distribution of relevant stimuli (targets) to improve detection at locations of high target probability. Is the ability to flexibly modify behavior based on visual experience unique to primates? Chickens (Gallus domesticus) were trained on a multiple alternative Go/NoGo task to detect a small, briefly-flashed dot (target) in each of the quadrants of the visual field. When targets were presented with equal probability (25%) in each quadrant, chickens exhibited a distinct advantage for detecting targets at lower, relative to upper, hemifield locations. Increasing the probability of presentation in the upper hemifield locations (to 80%) dramatically improved detection performance at these locations to be on par with lower hemifield performance. Finally, detection performance in the upper hemifield changed on a rapid timescale, improving with successive target detections, and declining with successive detections at the diagonally opposite location in the lower hemifield. These data indicate the action of a process that in chickens, as in primates, flexibly and dynamically modulates detection performance based on the spatial probabilities of sensory stimuli as well as on recent performance history. PMID:23734188

  8. Effect of duration and severity of migraine on retinal nerve fiber layer, ganglion cell layer, and choroidal thickness.

    PubMed

    Abdellatif, Mona K; Fouad, Mohamed M

    2018-03-01

    To investigate the factors in migraine that have the highest significance on retinal and choroidal layers' thickness. Ninety patients with migraine and 40 age-matched healthy participants were enrolled in this observational, cross-sectional study. After full ophthalmological examination, spectral domain-optical coherence tomography was done for all patients measuring the thickness of ganglion cell layer and retinal nerve fiber layer. Enhanced depth imaging technique was used to measure the choroidal thickness. There was significant thinning in the superior and inferior ganglion cell layers, all retinal nerve fiber layer quadrants, and all choroidal quadrants (except for the central subfield) in migraineurs compared to controls. The duration of migraine was significantly correlated with ganglion cell layer, retinal nerve fiber layer, and all choroidal quadrants, while the severity of migraine was significantly correlated with ganglion cell layer and retinal nerve fiber layer only. Multiregression analysis showed that the duration of migraine is the most important determinant factor of the superior retinal nerve fiber layer quadrant (β = -0.375, p = 0.001) and in all the choroidal quadrants (β = -0.531, -0.692, -0.503, -0.461, -0.564, respectively, p  < 0.001), while severity is the most important determinant factor of inferior, nasal, and temporal retinal nerve fiber layer quadrants (β = -0.256, -0.335, -0.308; p  = 0.036, 0.005, 0.009, respectively) and the inferior ganglion cell layer hemisphere (β = -0.377 and p = 0.001). Ganglion cell layer, retinal nerve fiber layer, and choroidal thickness are significantly thinner in patients with migraine. The severity of migraine has more significant influence in the thinning of ganglion cell layer and retinal nerve fiber layer, while the duration of the disease affected the choroidal thickness more.

  9. Duodenal Obstruction Caused by Acute Appendicitis with Intestinal Malrotation in a Child.

    PubMed

    Biçer, Şenol; Çelik, Ali

    2015-08-27

    In patients with intestinal malrotation, the diagnosis of acute appendicitis can be difficult due to atypical presentation. Duodenal obstruction caused by acute appendicitis with the presence of malrotation has rarely been reported in children. We report the case of a 14-year-old male patient with bilious vomiting and abdominal distension. A diagnosis could not be made by computed tomography, ultrasonography, or endoscopy. We observed a dilated stomach and malrotation in laparotomy. The caecum was in the right upper quadrant, and an inflamed appendix was located in the subhepatic region. After the appendectomy, the cecum was mobilized and fixed in the right lower quadrant. In children with intestinal malrotation, acute appendicitis can present as duodenal obstruction without abdominal pain, and standard imaging methods can miss the correct diagnosis.

  10. Seeing the Hidden Lamina: Effects of Exsanguination on the Optic Nerve Head

    PubMed Central

    Tran, Huong; Wallace, Jacob; Zhu, Ziyi; Lucy, Katie A.; Voorhees, Andrew P.; Schmitt, Samantha E.; Bilonick, Richard A.; Schuman, Joel S.; Smith, Matthew A.; Wollstein, Gadi; Sigal, Ian A.

    2018-01-01

    Purpose To introduce an experimental approach for direct comparison of the primate optic nerve head (ONH) before and after death by exsanguination. Method The ONHs of four eyes from three monkeys were imaged with spectral-domain optical coherence tomography (OCT) before and after exsanguination under controlled IOP. ONH structures, including the Bruch membrane (BM), BM opening, inner limiting membrane (ILM), and anterior lamina cribrosa (ALC) were delineated on 18 virtual radial sections per OCT scan. Thirteen parameters were analyzed: scleral canal at BM opening (area, planarity, and aspect ratio), ILM depth, BM depth; ALC (depth, shape index, and curvedness), and ALC visibility (globally, superior, inferior, nasal, and temporal quadrants). Results All four ALC quadrants had a statistically significant improvement in visibility after exsanguination (overall P < 0.001). ALC visibility increased by 35% globally and by 36%, 37%, 14%, and 4% in the superior, inferior, nasal, and temporal quadrants, respectively. ALC increased 4.1%, 1.9%, and 0.1% in curvedness, shape index, and depth, respectively. Scleral canals increased 7.2%, 25.2%, and 1.1% in area, planarity, and aspect ratio, respectively. ILM and BM depths averaged −7.5% and −55.2% decreases in depth, respectively. Most, but not all, changes were beyond the repeatability range. Conclusions Exsanguination allows for improved lamina characterization, especially in regions typically blocked by shadowing in OCT. The results also demonstrate changes in ONH morphology due to the loss of blood pressure. Future research will be needed to determine whether there are differences in ONH biomechanics before and after exsanguination and what those differences would imply. PMID:29847664

  11. Optical coherence tomography in papilledema and pseudopapilledema with and without optic nerve head drusen

    PubMed Central

    Bassi, Shikha Talwar; Mohana, Kuppuswamy Parthasarthy

    2014-01-01

    Aim: To compare the spectral domain optical coherence tomography (SD-OCT) findings of the optic disc and the peripapillary retina of patients with a true papilledema and pseudopapilledema with and without optic nerve head drusen (ONHD). Study Design: Retrospective Case Control Study. Subjects and Methods: Peripapillary retinal nerve fiber layer (PPRNFL) thickness as depicted by SD-OCT of 94 eyes of 66 patients with papilledema (30 eyes), pseudopapiledema (31 eyes), and normal controls (33 eyes) was analyzed. The mean RNFL thickness, total retinal thickness (TRT) at a superior and inferior edge of the disc and the quadrant wise topography of increased RNFL were compared in all three groups. Sensitivity, specificity, and area under the receiver operating characteristic curve (AROC) were calculated for all the parameters. Results: The median RNFL thickness was 185.4 (129.5–349.3 μm), 122.3 (109–156.3 μm) and 91.62 ± 7 μm in papilledema, pseudopapilledema, and controls, respectively. Papilledema group had thicker PPRNFL in all quadrants except temporal quadrant. TRT was thicker in papilledema and pseudopapilledema compared to controls. ONHD could be directly visualized as high reflective clumps in the sub-retinal space or the RNFL in 30 eyes. Increased RNFL thickness in all four quadrants was noted 43.3% in papilledema and 9.7% in pseudopapilledema. Normal RNFL thickness in all four quadrants was noted in 0% in papilledema and 32.3% in pseudopapilledema. Nasal RNFL had the highest AROC (0.792) indicating high diagnostic ability to differentiate papilledema from pseudopapilledema. Conclusion: SD-OCT can be used as a tool to differentiate between papilledema and pseudopapilledema. PMID:25579359

  12. Use of EyeCam for imaging the anterior chamber angle.

    PubMed

    Perera, Shamira A; Baskaran, Mani; Friedman, David S; Tun, Tin A; Htoon, Hla M; Kumar, Rajesh S; Aung, Tin

    2010-06-01

    To compare EyeCam (Clarity Medical Systems, Pleasanton, CA) imaging with gonioscopy for detecting angle closure. In this prospective, hospital-based study, subjects underwent gonioscopy by a single observer and EyeCam imaging by a different operator. EyeCam images were graded by two masked observers. The anterior chamber angle in a quadrant was classified as closed if the trabecular meshwork could not be seen. The eye was classified as having angle closure if two or more quadrants were closed. One hundred fifty-two subjects were studied. The mean age was 57.4 years (SD 12.9) and there were 82 (54%) men. Of the 152 eyes, 21 (13.8%) had angle closure. The EyeCam provided clear images of the angles in 98.8% of subjects. The agreement between the EyeCam and gonioscopy for detecting angle closure in the superior, inferior, nasal, and temporal quadrants based on agreement coefficient (AC1) statistics was 0.73, 0.75, 0.76, and 0.72, respectively. EyeCam detected more closed angles than did gonioscopy in all quadrants (P < 0.05). With gonioscopy, 21/152 (13.8%) eyes were diagnosed as angle closure compared to 41 (27.0%) of 152 with EyeCam (P < 0.001, McNemar Test), giving an overall sensitivity of 76.2% (95% confidence interval [CI], 54.9%-90.7%), specificity of 80.9% (95%CI, 73.5%-87.3%), and an area under the receiver operating characteristic curve (AUC) of 0.79. The EyeCam showed good agreement with gonioscopy for detecting angle closure. However, it detected more closed angles than did gonioscopy in all quadrants.

  13. 90. PORTLAND FILTER FLOOR FROM SOUTHEAST. CYANIDE FEED TOWER TO ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    90. PORTLAND FILTER FLOOR FROM SOUTHEAST. CYANIDE FEED TOWER TO SUMP, LOWER RIGHT QUADRANT. DIAGONAL PIPE IN UPPER RIGHT IS AIR LINE TO AGITATORS. LAUNDER PARALLEL TO LEFT EDGE (FILLED WITH DEBRIS) RUNS FROM PRIMARY THICKENER No. 2 TO GOLD TANK No. 2. - Bald Mountain Gold Mill, Nevada Gulch at head of False Bottom Creek, Lead, Lawrence County, SD

  14. 169. PORTLAND FILTER FLOOR FROM SOUTHEAST. CYANIDE FEED TOWER TO ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    169. PORTLAND FILTER FLOOR FROM SOUTHEAST. CYANIDE FEED TOWER TO SUMP, LOWER RIGHT QUADRANT. DIAGONAL PIPE IN UPPER RIGHT IS AIR LINE TO AGITATORS. LAUNDER PARALLEL TO LEFT EDGE (FILLED WITH DEBRIS) RUNS FROM PRIMARY THICKENER No. 2 TO GOLD TANK No. 2 - Bald Mountain Gold Mill, Nevada Gulch at head of False Bottom Creek, Lead, Lawrence County, SD

  15. Impact of Tumor Localization and Method of Preoperative Biopsy on Sentinel Lymph Node Mapping After Periareolar Nuclide Injection.

    PubMed

    Krammer, Julia; Dutschke, Anja; Kaiser, Clemens G; Schnitzer, Andreas; Gerhardt, Axel; Radosa, Julia C; Brade, Joachim; Schoenberg, Stefan O; Wasser, Klaus

    2016-01-01

    To evaluate whether tumor localization and method of preoperative biopsy affect sentinel lymph node (SLN) detection after periareolar nuclide injection in breast cancer patients. 767 breast cancer patients were retrospectively included. For lymphscintigraphy periareolar nuclide injection was performed and the SLN was located by gamma camera. Patient and tumor characteristics were correlated to the success rate of SLN mapping. SLN marking failed in 9/61 (14.7%) patients with prior vacuum-assisted biopsy and 80/706 (11.3%) patients with prior core needle biopsy. Individually evaluated, biopsy method (p = 0.4) and tumor localization (p = 0.9) did not significantly affect the SLN detection rate. Patients with a vacuum-assisted biopsy of a tumor in the upper outer quadrant had a higher odds ratio of failing in SLN mapping (OR 3.8, p = 0.09) compared to core needle biopsy in the same localization (OR 0.9, p = 0.5). Tumor localization and preoperative biopsy method do not significantly impact SLN mapping with periareolar nuclide injection. However, the failure risk tends to rise if vacuum-assisted biopsy of a tumor in the upper outer quadrant is performed.

  16. Laparoscopy in patients following transverse rectus abdominis myocutaneous flap reconstruction.

    PubMed

    Muller, C Y; Coleman, R L; Adams, W P

    2000-07-01

    We report our technique and experience performing laparoscopic pelvic surgery on four women after transverse abdominus rectus myocutaneous flap (TRAM). Examination under anesthesia is performed on all patients in the low lithotomy position parallel with the floor. The abdominal aorta is palpated and outlined. A pneumoperitoneum is created either by umbilical or left upper quadrant Veress placement. Patients with an acceptable umbilical location undergo port placement through the incision of the umbilical relocation. Other options include left upper quadrant or paramedian placement avoiding the ligamentum teres vessels. Lateral operative ports (5 mm) are placed with reference to the transverse incision present, the pelvic pathology, and the location of the umbilicus. Techniques of electrocautery, intra- and extracorporeal suturing and knot tying, and clips are preferred to minimize port size. Following unilateral or bilateral TRAM reconstruction, four consecutive breast cancer survivors underwent successful laparoscopic-assisted vaginal hysterectomy with oophorectomy using the periumbilical incision for trocar placement. The only complication was a superficial skin breakdown from an adhesive allergy that required 6 weeks for complete resolution. Laparoscopic pelvic surgery is feasible in women after TRAM reconstruction. Knowledge of anatomic and physiologic variations related to the TRAM procedure is necessary in planning a safe operation.

  17. Temporal dynamics of divided spatial attention

    PubMed Central

    Garcia, Javier O.; Serences, John T.

    2013-01-01

    In naturalistic settings, observers often have to monitor multiple objects dispersed throughout the visual scene. However, the degree to which spatial attention can be divided across spatially noncontiguous objects has long been debated, particularly when those objects are in close proximity. Moreover, the temporal dynamics of divided attention are unclear: is the process of dividing spatial attention gradual and continuous, or does it onset in a discrete manner? To address these issues, we recorded steady-state visual evoked potentials (SSVEPs) as subjects covertly monitored two flickering targets while ignoring an intervening distractor that flickered at a different frequency. All three stimuli were clustered within either the lower left or the lower right quadrant, and our dependent measure was SSVEP power at the target and distractor frequencies measured over time. In two experiments, we observed a temporally discrete increase in power for target- vs. distractor-evoked SSVEPs extending from ∼350 to 150 ms prior to correct (but not incorrect) responses. The divergence in SSVEP power immediately prior to a correct response suggests that spatial attention can be divided across noncontiguous locations, even when the targets are closely spaced within a single quadrant. In addition, the division of spatial attention appears to be relatively discrete, as opposed to slow and continuous. Finally, the predictive relationship between SSVEP power and behavior demonstrates that these neurophysiological measures of divided attention are meaningfully related to cognitive function. PMID:23390315

  18. Temporal dynamics of divided spatial attention.

    PubMed

    Itthipuripat, Sirawaj; Garcia, Javier O; Serences, John T

    2013-05-01

    In naturalistic settings, observers often have to monitor multiple objects dispersed throughout the visual scene. However, the degree to which spatial attention can be divided across spatially noncontiguous objects has long been debated, particularly when those objects are in close proximity. Moreover, the temporal dynamics of divided attention are unclear: is the process of dividing spatial attention gradual and continuous, or does it onset in a discrete manner? To address these issues, we recorded steady-state visual evoked potentials (SSVEPs) as subjects covertly monitored two flickering targets while ignoring an intervening distractor that flickered at a different frequency. All three stimuli were clustered within either the lower left or the lower right quadrant, and our dependent measure was SSVEP power at the target and distractor frequencies measured over time. In two experiments, we observed a temporally discrete increase in power for target- vs. distractor-evoked SSVEPs extending from ∼350 to 150 ms prior to correct (but not incorrect) responses. The divergence in SSVEP power immediately prior to a correct response suggests that spatial attention can be divided across noncontiguous locations, even when the targets are closely spaced within a single quadrant. In addition, the division of spatial attention appears to be relatively discrete, as opposed to slow and continuous. Finally, the predictive relationship between SSVEP power and behavior demonstrates that these neurophysiological measures of divided attention are meaningfully related to cognitive function.

  19. Upper quadrant port placement for robot-assisted renal surgery: implementation of the Floating Arm and the XL Protype.

    PubMed

    Totonchi, Samer; Elgin, Robert; Monahan, Michael; Johnston, William K

    2014-08-01

    Abstract Background and Purpose: Placement of the fourth arm (4th arm) in the lower quadrant (LQ) is commonly described for robot-assisted renal surgical procedures but has anatomic restrictions and limited ergonomics. An alternative, upper quadrant (UQ) location is desirable, but patient habitus and spacing may restrict robotic attachment. We investigate current trends in 4th arm port placement and propose an alternative method at attaching the robot-the "Floating Arm" (FLA). Robotic surgeons from the Endourological Society were surveyed. A 20-cm extra-long (XL Protype) da Vinci instrument was developed for the FLA technique. A dry lab allowed quantitative comparison of spacing and ranges of motion for standard da Vinci ports (dVP), bariatric dVP, telescoping dVP, and FLA. There were 108 respondents who participated. Half of the respondents avoid using the 4th arm (30% lack of need and 20% because of interference). The majority (90%) typically positions the 4th arm in the LQ, but many reported limitations in this location. Few (5%) place 4th arm in the UQ, while most (73%) have never heard of UQ placement. Existing techniques may increase shoulder height clearance but inversely shorten the working length of the instrument intracorporeally. Alternatively, the XL Protype significantly increased the shoulder length and maintained available working distances intracorporeally. Adjacent arm interference angle was essentially identical (27 degrees) for all ports except a greater range of movement for the XL Protype (35 degrees). Few surgeons are using an UQ positioning or use techniques to improve attachment of the 4th arm. The greatest freedom may be obtained by implementing the FLA, but this necessitates production of a longer instrument.

  20. A 12 month clinical study of bond failures of recycled versus new stainless steel orthodontic brackets.

    PubMed

    Cacciafesta, Vittorio; Sfondrini, Maria Francesca; Melsen, Birte; Scribante, Andrea

    2004-08-01

    The purpose of this prospective longitudinal randomized study was to compare the clinical performance of recycled brackets with that of new stainless steel brackets (Orthos). Twenty patients treated with fixed appliances were included in the investigation. Using a 'split-mouth' design, the dentition of each patient was divided into four quadrants. In 11 randomly selected patients, the maxillary left and mandibular right quadrants were bonded with recycled brackets, and the remaining quadrants with new stainless steel brackets. In the other nine patients the quadrants were inverted. Three hundred and ten stainless steel brackets were examined: 156 were recycled and the remaining 154 were new. All the brackets were bonded with a self-cured resin-modified glass ionomer (GC Fuji Ortho). The number, cause, and date of bracket failures were recorded over 12 months. Statistical analysis was performed by means of a paired t-test, Kaplan-Meier survival estimates, and the log-rank test. No statistically significant differences were found between: (a) the total bond failure rate of recycled and new stainless steel brackets; (b) the upper and lower arches; (c) the anterior and posterior segments. These findings demonstrate that recycling metallic orthodontic brackets can be of benefit to the profession, both economically and ecologically, as long as the orthodontist is aware of the various aspects of the recycling methods, and that patients are informed about the type of bracket that will be used for their treatment.

  1. Morphologic evaluations of Q-switched Nd:YAG laser injury of human retina

    NASA Astrophysics Data System (ADS)

    Scales, David K.; Schuschereba, Steven T.; Lund, David J.; Stuck, Bruce E.

    1997-05-01

    Depiction of the cellular and immune responses in the human model is critical to design rational therapies preventing/limiting cellular destruction and ultimately functional visual loss following acute laser injuries. We report the light and electron microscopy histologic findings in a controlled ocular human laser exposure. Following informed consent, the normal eye of a patient scheduled to undergo exenteration for invasive carcinoma of the orbit was exposed to both continuous wave and Q-switched lasers. Four hours prior to exenteration, argon G lesions were placed in the superior/temporal quadrant and Nd:YAG lesions were placed in the inferior/temporal quadrant. After enucleation, the retina was prepared for routine light and transmission electron microscopy. Histology of the argon G lesions showed primarily photoreceptor and RPE photocoagulation damage. Neutrophil adhesion was limited within the choroid and no neutrophils were observed in the subretinal space. In contrast, the 4 hr Nd:YAG lesions showed extensive retinal disruption, hemorrhage within subretinal and intraretinal spaces, neutrophil accumulation in the retina, and an extensive neutrophil chemotaxic and emigration response in the choroid. Severe laser injuries elicit a significant neutrophil response by 4 hr, suggesting that neutrophils should be an early stage therapeutic target.

  2. Splenic infarct in a patient with Infectious Mononucleosis: a rare presentation

    PubMed Central

    Noor, Mustafa; Sadough, Maryam; Chan, Stephanie; Singh, Gurkeerat

    2017-01-01

    ABSTRACT We report a case of a 25-year-old obese, currently smoking, female diagnosed with EBV infectious mononucleosis. The patient complained of sudden onset abdominal pain with progressively increasing intensity in the left upper quadrant. Abdominal CT scan showed a wedge infarct of the spleen. We present this rare case that EBV may cause splenic infarct in young adults. PMID:29046754

  3. Upper-Air Quality Control, A Comparison Study

    DTIC Science & Technology

    1993-12-01

    hydrostatic different quadrant . From these four increments the check is based on the redundancy of reported value of the point in question is interpolated...NUAV COCHT NUAV Europa (01-17) 5,347 4,900 214 432 4.00 8.82 Former USSR (20-38) 9,152 8,824 838 704 9.16 .98 Aa (40-41, 44-48) 3,868 3,797 443 295 11.45

  4. Earth observation taken by the Expedition 28 crew

    NASA Image and Video Library

    2011-09-07

    ISS028-E-043559 (7 Sept. 2011) --- This view, from the camera of an Expedition 28 crew member onboard the International Space Station, looks from the northwest toward southeast and covers many counties in southeast Texas that have been heavily affected by dozens of wild fires. Houston can be seen near frame center and the Gulf of Mexico takes up the upper right quadrant of the frame.

  5. Assessment of Different Sampling Methods for Measuring and Representing Macular Cone Density Using Flood-Illuminated Adaptive Optics.

    PubMed

    Feng, Shu; Gale, Michael J; Fay, Jonathan D; Faridi, Ambar; Titus, Hope E; Garg, Anupam K; Michaels, Keith V; Erker, Laura R; Peters, Dawn; Smith, Travis B; Pennesi, Mark E

    2015-09-01

    To describe a standardized flood-illuminated adaptive optics (AO) imaging protocol suitable for the clinical setting and to assess sampling methods for measuring cone density. Cone density was calculated following three measurement protocols: 50 × 50-μm sampling window values every 0.5° along the horizontal and vertical meridians (fixed-interval method), the mean density of expanding 0.5°-wide arcuate areas in the nasal, temporal, superior, and inferior quadrants (arcuate mean method), and the peak cone density of a 50 × 50-μm sampling window within expanding arcuate areas near the meridian (peak density method). Repeated imaging was performed in nine subjects to determine intersession repeatability of cone density. Cone density montages could be created for 67 of the 74 subjects. Image quality was determined to be adequate for automated cone counting for 35 (52%) of the 67 subjects. We found that cone density varied with different sampling methods and regions tested. In the nasal and temporal quadrants, peak density most closely resembled histological data, whereas the arcuate mean and fixed-interval methods tended to underestimate the density compared with histological data. However, in the inferior and superior quadrants, arcuate mean and fixed-interval methods most closely matched histological data, whereas the peak density method overestimated cone density compared with histological data. Intersession repeatability testing showed that repeatability was greatest when sampling by arcuate mean and lowest when sampling by fixed interval. We show that different methods of sampling can significantly affect cone density measurements. Therefore, care must be taken when interpreting cone density results, even in a normal population.

  6. In vivo imaging of palisades of Vogt in dry eye versus normal subjects using en-face spectral-domain optical coherence tomography.

    PubMed

    Ghouali, Wajdene; Tahiri Joutei Hassani, Rachid; Djerada, Zoubir; Liang, Hong; El Sanharawi, Mohamed; Labbé, Antoine; Baudouin, Christophe

    2017-01-01

    To evaluate a possible clinical application of spectral-domain optical coherence tomography (SD-OCT) using en-face module for the imaging of the corneoscleral limbus in normal subjects and dry eye patients. Seventy-six subjects were included in this study. Seventy eyes of 35 consecutive patients with dry eye disease and 82 eyes of 41 healthy control subjects were investigated. All subjects were examined with the Avanti RTVue® anterior segment OCT. En-face OCT images of the corneoscleral limbus were acquired in four quadrants (inferior, superior, nasal and temporal) and then were analyzed semi-quantitatively according to whether or not palisades of Vogt (POV) were visible. En-face OCT images were then compared to in vivo confocal microscopy (IVCM) in eleven eyes of 7 healthy and dry eye patients. En-face SD-OCT showed POV as a radially oriented network, located in superficial corneoscleral limbus, with a good correlation with IVCM features. It provided an easy and reproducible identification of POV without any special preparation or any direct contact, with a grading scale from 0 (no visualization) to 3 (high visualization). The POV were found predominantly in superior (P<0.001) and inferior (P<0.001) quadrants when compared to the nasal and temporal quadrants for all subjects examined. The visibility score decreased with age (P<0.001) and was lower in dry eye patients (P<0.01). In addition, the score decreased in accordance with the severity of dry eye disease (P<0.001). En-face SD-OCT is a non-contact imaging technique that can be used to evaluate the POV, thus providing valuable information about differences in the limbal anatomy of dry eye patients as compared to healthy patients.

  7. Assessment of Different Sampling Methods for Measuring and Representing Macular Cone Density Using Flood-Illuminated Adaptive Optics

    PubMed Central

    Feng, Shu; Gale, Michael J.; Fay, Jonathan D.; Faridi, Ambar; Titus, Hope E.; Garg, Anupam K.; Michaels, Keith V.; Erker, Laura R.; Peters, Dawn; Smith, Travis B.; Pennesi, Mark E.

    2015-01-01

    Purpose To describe a standardized flood-illuminated adaptive optics (AO) imaging protocol suitable for the clinical setting and to assess sampling methods for measuring cone density. Methods Cone density was calculated following three measurement protocols: 50 × 50-μm sampling window values every 0.5° along the horizontal and vertical meridians (fixed-interval method), the mean density of expanding 0.5°-wide arcuate areas in the nasal, temporal, superior, and inferior quadrants (arcuate mean method), and the peak cone density of a 50 × 50-μm sampling window within expanding arcuate areas near the meridian (peak density method). Repeated imaging was performed in nine subjects to determine intersession repeatability of cone density. Results Cone density montages could be created for 67 of the 74 subjects. Image quality was determined to be adequate for automated cone counting for 35 (52%) of the 67 subjects. We found that cone density varied with different sampling methods and regions tested. In the nasal and temporal quadrants, peak density most closely resembled histological data, whereas the arcuate mean and fixed-interval methods tended to underestimate the density compared with histological data. However, in the inferior and superior quadrants, arcuate mean and fixed-interval methods most closely matched histological data, whereas the peak density method overestimated cone density compared with histological data. Intersession repeatability testing showed that repeatability was greatest when sampling by arcuate mean and lowest when sampling by fixed interval. Conclusions We show that different methods of sampling can significantly affect cone density measurements. Therefore, care must be taken when interpreting cone density results, even in a normal population. PMID:26325414

  8. Deformation of the Early Glaucomatous Monkey Optic Nerve Head Connective Tissue after Acute IOP Elevation in 3-D Histomorphometric Reconstructions

    PubMed Central

    Yang, Hongli; Thompson, Hilary; Roberts, Michael D.; Sigal, Ian A.; Downs, J. Crawford

    2011-01-01

    Purpose. To retest the hypothesis that monkey ONH connective tissues become hypercompliant in early experimental glaucoma (EEG), by using 3-D histomorphometric reconstructions, and to expand the characterization of EEG connective tissue deformation to nine EEG eyes. Methods. Trephinated ONH and peripapillary sclera from both eyes of nine monkeys that were perfusion fixed, with one normal eye at IOP 10 mm Hg and the other EEG eye at 10 (n = 3), 30 (n = 3), or 45 (n = 3) mm Hg were serial sectioned, 3-D reconstructed, 3-D delineated, and quantified with 3-D reconstruction techniques developed in prior studies by the authors. Overall, and for each monkey, intereye differences (EEG eye minus normal eye) for each parameter were calculated and compared by ANOVA. Hypercompliance in the EEG 30 and 45 eyes was assessed by ANOVA, and deformations in all nine EEG eyes were separately compared by region without regard for fixation IOP. Results. Hypercompliant deformation was not significant in the overall ANOVA, but was suggested in a subset of EEG 30/45 eyes. EEG eye deformations included posterior laminar deformation, neural canal expansion, lamina cribrosa thickening, and posterior (outward) bowing of the peripapillary sclera. Maximum posterior laminar deformation and scleral canal expansion co-localized to either the inferior nasal or superior temporal quadrants in the eyes with the least deformation and involved both quadrants in the eyes achieving the greatest deformation. Conclusions. The data suggest that, in monkey EEG, ONH connective tissue hypercompliance may occur only in a subset of eyes and that early ONH connective tissue deformation is maximized in the superior temporal and/or inferior nasal quadrants. PMID:20702834

  9. Influence of Photobiomodulation Therapy on Gingivitis Induced by Multi-Bracket Appliances: A Split-Mouth Randomized Controlled Trial.

    PubMed

    Stein, Steffen; Schauseil, Michael; Hellak, Andreas; Korbmacher-Steiner, Heike; Braun, Andreas

    2018-05-18

    The objective of this split-mouth trial was to investigate the influence of photobiomodulation therapy (PBMT) on adjuvant treatment of gingivitis induced by multi-bracket appliances, after bracket debonding and professional tooth cleaning. Thirteen patients (mean age 16.15 years; standard deviation ±2.12 years) who had completed active orthodontic treatment with fixed orthodontic appliances in an orthodontic clinic were included on a randomized basis. At time point T0, after bracket debonding and professional tooth cleaning, the papilla bleeding index (PBI) and bleeding on probing (BOP) were assessed in the upper jaw by the blinded investigator (M.S.), who was not aware at any time of which quadrant received PBMT. The study was based on a patient-blinded split-mouth design. In each patient, PBMT was administered by a practitioner (S.S.) in one upper quadrant (wavelength: 660 nm; Power: 100 mW; Power density: 100 mW/cm 2 ; Energy density per application point = 2 J/cm 2 ; Energy per application point = 2 J; Total dose = 52 J/cm 2 ; Total energy = 52 J; Irradiation time: 26 × 20 sec), while the other upper quadrant received a simulated laser application with the laser system turned off. Randomized equal allocation of the sides was accomplished. The second PBI and BOP assessment followed 4-6 days after laser irradiation (T1) by M.S. No statistical differences were observed between the sides with regard to PBI and BOP values at T0 (p > 0.05). The PBI and BOP values decreased significantly between T0 and T1 on both sides (p < 0.05). At T1, the PBI and BOP values were significantly lower in the laser side in comparison with the control side (p < 0.05). On the basis of these results and study parameters, adjuvant PBMT is able to accelerate the healing process in patients with gingivitis induced by multi-bracket appliances.

  10. Charactering lidar optical subsystem using four quadrants method

    NASA Astrophysics Data System (ADS)

    Tian, Xiaomin; Liu, Dong; Xu, Jiwei; Wang, Zhenzhu; Wang, Bangxin; Wu, Decheng; Zhong, Zhiqing; Xie, Chenbo; Wang, Yingjian

    2018-02-01

    Lidar is a kind of active optical remote sensing instruments , can be applied to sound atmosphere with a high spatial and temporal resolution. Many parameter of atmosphere can be get by using different inverse algorithm with lidar backscatter signal. The basic setup of a lidar consist of a transmitter and a receiver. To make sure the quality of lidar signal data, the lidar must be calibrated before being used to measure the atmospheric variables. It is really significant to character and analyze lidar optical subsystem because a well equiped lidar optical subsystem contributes to high quality lidar signal data. we pay close attention to telecover test to character and analyze lidar optical subsystem.The telecover test is called four quadrants method consisting in dividing the telescope aperture in four quarants. when a lidar is well configured with lidar optical subsystem, the normalized signal from four qudrants will agree with each other on some level. Testing our WARL-II lidar by four quadrants method ,we find the signals of the four basically consistent with each other both in near range and in far range. But in detail, the signals in near range have some slight distinctions resulting from overlap function, some signals distinctions are induced by atmospheric instability.

  11. A Sharp Lesson: Duodenal Perforation 2 Months after Ingestion of a Pin.

    PubMed

    Dalrymple, Rebecca Amy; Berry, Kathleen; Jester, Ingo

    2017-01-01

    An 11-year-old female child presented 2 months after accidentally swallowing her hijab pin, with right-sided abdominal pain. An X-ray showed that the pin was located in her right upper quadrant, and at laparoscopy, it was found to have eroded through her duodenum into her liver. Ingested pins should always be removed if not passed spontaneously within the first few days.

  12. A Sharp Lesson: Duodenal Perforation 2 Months after Ingestion of a Pin

    PubMed Central

    Dalrymple, Rebecca Amy; Berry, Kathleen; Jester, Ingo

    2017-01-01

    An 11-year-old female child presented 2 months after accidentally swallowing her hijab pin, with right-sided abdominal pain. An X-ray showed that the pin was located in her right upper quadrant, and at laparoscopy, it was found to have eroded through her duodenum into her liver. Ingested pins should always be removed if not passed spontaneously within the first few days. PMID:28694580

  13. The plaque- and gingivitis-inhibiting capacity of a commercially available essential oil product. A parallel, split-mouth, single blind, randomized, placebo-controlled clinical study.

    PubMed

    Preus, Hans Ragnar; Koldsland, Odd Carsten; Aass, Anne Merete; Sandvik, Leiv; Hansen, Bjørn Frode

    2013-11-01

    Studies have reported commercially available essential oils with convincing plaque and gingivitis preventing properties. However, no tests have compared these essential oils, i.e. Listerine(®), against their true vehicle controls. To compare the plaque and gingivitis inhibiting effect of a commercially-available essential oil (Listerine(®) Total Care) to a negative (22% hydro-alcohol solution) and a positive (0.2% chlorhexidine (CHX)) control in an experimental gingivitis model. In three groups of 15 healthy volunteers, experimental gingivitis was induced and monitored over 21 days, simultaneously treated with Listerine(®) Total Care (test), 22% hydro-alcohol solution (negative control) and 0.2% chlorhexidine solution (positive control), respectively. The upper right quadrant of each individual received mouthwash only, whereas the upper left quadrant was subject to both rinses and mechanical oral hygiene. Plaque, gingivitis and side-effects were assessed at day 7, 14 and 21. After 21 days, the chlorhexidine group showed significantly lower average plaque and gingivitis scores than the Listerine(®) and alcohol groups, whereas there was little difference between the two latter. Listerine(®) Total Care had no statistically significant effect on plaque formation as compared to its vehicle control.

  14. Carbon dioxide embolism during laparoscopic sleeve gastrectomy

    PubMed Central

    Zikry, Amir Abu; DeSousa, Kalindi; Alanezi, Khaled H

    2011-01-01

    Bariatric restrictive and malabsorptive operations are being carried out in most countries laparoscopically. Carbon dioxide or gas embolism has never been reported in obese patients undergoing bariatric surgery. We report a case of carbon dioxide embolism during laparoscopic sleeve gastrectomy (LSG) in a young super obese female patient. Early diagnosis and successful management of this complication are discussed. An 18-year-old super obese female patient with enlarged fatty liver underwent LSG under general anesthesia. During initial intra-peritoneal insufflation with CO2 at high flows through upper left quadrant of the abdomen, she had precipitous fall of end-tidal CO2 and SaO2 % accompanied with tachycardia. Early suspicion led to stoppage of further insufflation. Clinical parameters were stabilized after almost 30 min, while the blood gas analysis was restored to normal levels after 1 h. The area of gas entrainment on the damaged liver was recognized by the surgeon and sealed and the surgery was successfully carried out uneventfully. Like any other laparoscopic surgery, carbon dioxide embolism can occur during bariatric laparoscopic surgery also. Caution should be exercised when Veress needle is inserted through upper left quadrant of the abdomen in patients with enlarged liver. A high degree of suspicion and prompt collaboration between the surgeon and anesthetist can lead to complete recovery from this potentially fatal complication. PMID:21772696

  15. Characteristics of Upper Quadrant Posture of Young Women with Temporomandibular Disorders

    PubMed Central

    Uritani, Daisuke; Kawakami, Tetsuji; Inoue, Tomohiro; Kirita, Tadaaki

    2014-01-01

    [Purpose] This study aimed to investigate the characteristics of upper quadrant posture of young women with temporomandibular disorders. [Subjects] The participants were 19 female patients with temporomandibular disorders (patient group: mean age, 30.1 years) and 14 controls (control group: mean age, 24.6 years). [Methods] Outcome measures were the neck inclination angle (formed by a line connecting C7 and the ear tragus with a horizontal line), the angle of the shoulder (formed by a line connecting C7 and the acromial angle with a horizontal line), the cranial rotation angle (formed by a line connecting the ear tragus and the corner of the eye with a horizontal line), and the neck-length/shoulder-width ratio [the ratio of the neck length (from C7 to the tragus) to the width of the shoulder between the acromial angle]. The maximum range of mouth opening was measured using a scale. [Results] The neck inclination angle and maximum range of mouth opening were significantly smaller in the patient group than in the control group. No significant differences were observed in the other outcome measures between the two groups. [Conclusion] Temporomandibular disorders with limited mouth opening in young females are associated with the head position relative to the trunk. PMID:25276038

  16. Gonioscopy and ultrasound biomicroscopy in the detection of angle closure in patients with shallow anterior chamber.

    PubMed

    Cui, Shan-shan; Zou, Yan-hong; Li, Qian; Li, Li-na; Zhang, Ning; Liu, Xi-pu

    2014-12-01

    To assess the agreement between gonioscopy and ultrasound biomicroscopy (UBM) in detecting angle closure in Chinese patients with shallow anterior chamber. An observational comparative study of the two different examination methods was conducted. Patients with normal intraocular pressure and temporal peripheral anterior chamber depth less than a quarter of corneal thickness based on slit lamp examination were included in this study from December 2007 to May 2009 in the outpatient clinic of First Hospital of Tsinghua University. Gonioscopy was performed with a Goldman goniolens in dark room first and followed by full beam light and indentation. If the filtering trabecular meshwork was invisible or any peripheral anterior synechia was found, that quadrant of the angle was considered closed. UBM was first undertaken in a darkened room then repeated with normal room lighting. If iridotrabecular apposition was showed, that quadrant of the angle was considered closed. The status of angle closure of each quadrant with different methods was recorded. 85 eyes of 46 patients were included in this study. The agreement between gonioscopy and UBM was poor (Κ<0.4) with Kappa analysis in both dark and light conditions in each quadrant. The accordance of agreement between gonioscopy and UBM was hardly affected by age or sex, while in dark condition, eyes with deeper anterior chamber (P=0.005) or plateau iris configuration tended to produce different results (P=0.075) in the 2 methods. Gonioscopy and UBM are both indispensable methods for detecting angle closure, neither can completely replace the other.

  17. Angle assessment by EyeCam, goniophotography, and gonioscopy.

    PubMed

    Baskaran, Mani; Perera, Shamira A; Nongpiur, Monisha E; Tun, Tin A; Park, Judy; Kumar, Rajesh S; Friedman, David S; Aung, Tin

    2012-09-01

    To compare EyeCam (Clarity Medical Systems, Pleasanton, CA) and goniophotography in detecting angle closure, using gonioscopy as the reference standard. In this hospital-based, prospective, cross-sectional study, participants underwent gonioscopy by a single observer, and EyeCam imaging and goniophotography by different operators. The anterior chamber angle in a quadrant was classified as closed if the posterior trabecular meshwork could not be seen. A masked observer categorized the eyes as per the number of closed quadrants, and an eye was classified as having angle closure if there were 2 or more quadrants of closure. Agreement between the methods was analyzed by κ statistic and comparison of area under receiver operating characteristic curves (AUC). Eighty-five participants (85 eyes) were included, the majority of whom were Chinese. Angle closure was detected in 38 eyes (45%) with gonioscopy, 40 eyes (47%) using EyeCam, and 40 eyes (47%) with goniophotography (P=0.69 in both comparisons, McNemar test). The agreement for angle closure diagnosis (by eye) between gonioscopy and the 2 imaging modalities was high (κ=0.86; 95% Confidence Interval (CI), 0.75-0.97), whereas the agreement between EyeCam and goniophotography was not as good (κ=0.72; 95% CI, 0.57-0.87); largely due to lack of agreement in the nasal and temporal quadrants (κ=0.55 to 0.67). The AUC for detecting eyes with gonioscopic angle closure was similar for goniophotography and EyeCam (AUC 0.93, sensitivity=94.7%, specificity=91.5%; P>0.95). EyeCam and goniophotography have similarly high sensitivity and specificity for the detection of gonioscopic angle closure.

  18. Anatomical Evidence for Classical and Extra-classical Receptive Field Completion Across the Discontinuous Horizontal Meridian Representation of Primate Area V2

    PubMed Central

    Jeffs, Janelle; Ichida, Jennifer M.; Federer, Frederick

    2009-01-01

    In primates, a split of the horizontal meridian (HM) representation at the V2 rostral border divides this area into dorsal (V2d) and ventral (V2v) halves (representing lower and upper visual quadrants, respectively), causing retinotopically neighboring loci across the HM to be distant within V2. How is perceptual continuity maintained across this discontinuous HM representation? Injections of neuroanatomical tracers in marmoset V2d demonstrated that cells near the V2d rostral border can maintain retinotopic continuity within their classical and extra-classical receptive field (RF), by making both local and long-range intra- and interareal connections with ventral cortex representing the upper visual quadrant. V2d neurons located <0.9–1.3 mm from the V2d rostral border, whose RFs presumably do not cross the HM, make nonretinotopic horizontal connections with V2v neurons in the supra- and infragranular layers. V2d neurons located <0.6–0.9 mm from the border, whose RFs presumably cross the HM, in addition make retinotopic local connections with V2v neurons in layer 4. V2d neurons also make interareal connections with upper visual field regions of extrastriate cortex, but not of MT or MTc outside the foveal representation. Labeled connections in ventral cortex appear to represent the “missing” portion of the connectional fields in V2d across the HM. We conclude that connections between dorsal and ventral cortex can create visual field continuity within a second-order discontinuous visual topography. PMID:18755777

  19. Investigating brain functional evolution and plasticity using microelectrode array technology.

    PubMed

    Napoli, Alessandro; Obeid, Iyad

    2015-10-01

    The aim of this work was to investigate long and short-term plasticity responsible for memory formation in dissociated neuronal networks. In order to address this issue, a set of experiments was designed and implemented in which the microelectrode array electrode grid was divided into four quadrants, two of which were chronically stimulated, every two days for one hour with a stimulation paradigm that varied over time. Overall network and quadrant responses were then analyzed to quantify what level of plasticity took place in the network and how this was due to the stimulation interruption. The results demonstrate that there were no spatial differences in the stimulus-evoked activity within quadrants. Furthermore, the implemented stimulation protocol induced depression effects in the neuronal networks as demonstrated by the consistently lower network activity following stimulation sessions. Finally, the analysis demonstrated that the inhibitory effects of the stimulation decreased over time, thus suggesting a habituation phenomenon. These findings are sufficient to conclude that electrical stimulation is an important tool to interact with dissociated neuronal cultures, but localized stimuli are not enough to drive spatial synaptic potentiation or depression. On the contrary, the ability to modulate synaptic temporal plasticity was a feasible task to achieve by chronic network stimulation. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Military Application of Networking by Touch in Collaborative Planning and Tactical Environments

    DTIC Science & Technology

    2007-09-01

    the network. For example, processing, or understanding, four plus pages per second, let alone 1500 pages, far surpasses a normal user’s ability to...discovering rapid, evolutionary approaches for filtering four to 1500 pages per second into knowledgeable forms relevant to the user. Unless we...weapons at the ready when the TL receives a slight vibration in the upper right quadrant of a vest he is wearing. The familiar tactile sensation

  1. Annual Tropical Cyclone Report 1980

    DTIC Science & Technology

    1980-01-01

    north of the (926 km) south- southeast of Guam cn 16 March. surface center. Although two land stations During the early part of the year, intense reported...260615Z wheu improved agery which showed improved upper-level out- organization of the cloud pattern (Fig. 3- flow in the southeast quadrant (Fig. 3-01-1...moved south-o - uthwvst until it began to be conservative because satellite imagery recurvature to the southeast at the ridge of a developing tropical

  2. Four impacted fourth molars in a young patient: a case report

    PubMed Central

    CLEMENTINI, M.; OTTRIA, L.; PANDOLFI, C.; AGRESTINI, C.; BARLATTANI, A.

    2013-01-01

    Summary The occurrence of supernumerary teeth is a relatively uncommon dental anomaly and it’s rare for patients to have impacted fourth molars in all quadrant. Aim of this work is to describe the presence of bilateral fourth molars in the maxilla and the mandible in a young male patient aged 22 years came to our hospital with acute pericoronal infection around unerupted third inferior molars. Routine radiographic examination revealed impacted inferior third molars but also unerupted bilateral upper and inferior fourth molars. The acute infection was treated by local measures and the patient was subsequently admitted for removal of third and fourth impacted upper and lower molars under general anesthesia. PMID:23741604

  3. A Simple and Reliable Technique to Orient Donor Corneal Tissue Using the Radial Width of the Surgical Limbus.

    PubMed

    Aldrich, Benjamin T; Stockman, Adam M; Freiburger, Monica J; Shinkunas, Todd J; Burckart, Kimberlee A; Schmidt, Gregory A; Reed, Cynthia R; Zimmerman, M Bridget; Goins, Kenneth M; Wagoner, Michael D; Greiner, Mark A

    2015-12-01

    To develop a method based on identification of the widest region of the surgical limbus that can yield quick and accurate orientation of excised human donor corneas. Corneoscleral tissue from donors 49 to 75 years old was marked at the temporal sclera at the time of recovery. Digital images obtained from 20 corneas stored in viewing chambers, retroilluminated and viewed from the endothelial side, were used to quantify the per-degree radial width of the surgical limbus, defined as the distance from the scleral spur to clear cornea. To evaluate differences in radial width among regions, measurements were compared with the intracorneal mean limbal width, and a per-degree z-score was calculated by averaging among corneas. Using images of corneas with the temporal mark masked and the sidedness known, 6 observers were subjected to a blinded trial of 10 corneas to determine the central point of the widest limbal region of each cornea. Compared with the intracorneal mean, the mean radial width of the surgical limbus was greatest in the superior quadrant, and the difference compared with the inferior, nasal, and temporal quadrants was significant (P < 0.0001). The superior region was identified with 100% accuracy in blinded trials. The average absolute difference between the predicted and actual central point of the superior limbus was 9.75 ± 0.30 degrees. The radial width of the surgical limbus is greatest in the superior region of the cornea and can be used as a diagnostic feature to orient donor corneal tissue.

  4. Presence of Peripheral Neuropathy Is Associated With Progressive Thinning of Retinal Nerve Fiber Layer in Type 1 Diabetes.

    PubMed

    Dehghani, Cirous; Srinivasan, Sangeetha; Edwards, Katie; Pritchard, Nicola; Russell, Anthony W; Malik, Rayaz A; Efron, Nathan

    2017-05-01

    Reduced retinal nerve fiber layer (RNFL) thickness has been demonstrated in patients with diabetic peripheral neuropathy (DPN) in cross-sectional studies. This prospective study defines longitudinal alterations to the RNFL thickness in individuals with type 1 diabetes without (DPN-ve) and with (DPN+ve) DPN and in relation to risk factors for nerve damage. A cohort of 105 individuals with type 1 diabetes (20% DPN+ve) with predominantly mild or no retinopathy and no previous retinal photocoagulation underwent spectral-domain optical coherence tomography (SD-OCT) at baseline, 2 years, and 4 years. SD-OCT scans were acquired at 3.45-mm diameter around the optic nerve head and the overall RNFL and RNFL in the nasal, superior, temporal, and inferior quadrants were quantified. By including serial quantified RNFL parameters, linear mixed models were applied to assess the change in RNFL thickness over time and to explore the associations with other clinical variables. There was a significant decline in the overall RNFL thickness (-0.7 μm/y, P = 0.02) and RNFL in the superior quadrant (-1.9 μm/y, P < 0.01) in the DPN+ve group compared with DPN-ve group. The overall RNFL thickness and RNFL in the superior and nasal quadrants were inversely associated with age (β = -0.29, -0.41, and -0.29, respectively; P ≤ 0.02). Sex, retinopathy, diabetes duration, hemoglobin A1c, lipid profile, blood pressure, cigarette use, alcohol consumption, and body mass index did not show any significant effects (P > 0.05). Individuals with DPN showed a progressive RNFL thinning overall and in the superior quadrant, which was more pronounced in older individuals. There may be common pathways for retinal and peripheral neurodegeneration that are independent of conventional DPN risk factors.

  5. Multi-nucleate retinal pigment epithelium cells of the human macula exhibit a characteristic and highly specific distribution.

    PubMed

    Starnes, Austin C; Huisingh, Carrie; McGwin, Gerald; Sloan, Kenneth R; Ablonczy, Zsolt; Smith, R Theodore; Curcio, Christine A; Ach, Thomas

    2016-01-01

    The human retinal pigment epithelium (RPE) is reportedly 3% bi-nucleated. The importance to human vision of multi-nucleated (MN)-RPE cells could be clarified with more data about their distribution in central retina. Nineteen human RPE-flatmounts (9 ≤ 51 years, 10 > 80 years) were imaged at 12 locations: 3 eccentricities (fovea, perifovea, near periphery) in 4 quadrants (superior, inferior, temporal, nasal). Image stacks of lipofuscin-attributable autofluorescence and phalloidin labeled F-actin cytoskeleton were obtained using a confocal fluorescence microscope. Nuclei were devoid of autofluorescence and were marked using morphometric software. Cell areas were approximated by Voronoi regions. Mean number of nuclei per cell among eccentricity/quadrant groups and by age were compared using Poisson and binominal regression models. A total of 11,403 RPE cells at 200 locations were analyzed: 94.66% mono-, 5.31% bi-, 0.02% tri-nucleate, and 0.01% with 5 nuclei. Age had no effect on number of nuclei. There were significant regional differences: highest frequencies of MN-cells were found at the perifovea (9.9%) and near periphery (6.8%). The fovea lacked MN-cells almost entirely. The nasal quadrant had significantly more MN-cells compared to other quadrants, at all eccentricities. This study demonstrates MN-RPE cells in human macula. MN-cells may arise due to endoreplication, cell fusion, or incomplete cell division. The topography of MN-RPE cells follows the topography of photoreceptors; with near-absence at the fovea (cones only) and high frequency at perifovea (highest rod density). This distribution might reflect specific requirements of retinal metabolism or other mechanisms addressable in further studies.

  6. The Retinotopic Organization of Macaque Occipitotemporal Cortex Anterior to V4 and Caudoventral to the Middle Temporal (MT) Cluster

    PubMed Central

    Janssens, Thomas; Orban, Guy A.

    2014-01-01

    The retinotopic organization of macaque occipitotemporal cortex rostral to area V4 and caudorostral to the recently described middle temporal (MT) cluster of the monkey (Kolster et al., 2009) is not well established. The proposed number of areas within this region varies from one to four, underscoring the ambiguity concerning the functional organization in this region of extrastriate cortex. We used phase-encoded retinotopic functional MRI mapping methods to reveal the functional topography of this cortical domain. Polar-angle maps showed one complete hemifield representation bordering area V4 anteriorly, split into dorsal and ventral counterparts corresponding to the lower and upper visual field quadrants, respectively. The location of this hemifield representation corresponds to area V4A. More rostroventrally, we identified three other complete hemifield representations. Two of these correspond to the dorsal and the ventral posterior inferotemporal areas (PITd and PITv, respectively) as identified in the Felleman and Van Essen (1991) scheme. The third representation has been tentatively named dorsal occipitotemporal area (OTd). Areas V4A, PITd, PITv, and OTd share a central visual field representation, similar to the areas constituting the MT cluster. Furthermore, they vary widely in size and represent the complete contralateral visual field. Functionally, these four areas show little motion sensitivity, unlike those of the MT cluster, and two of them, OTd and PITd, displayed pronounced two-dimensional shape sensitivity. In general, these results suggest that retinotopically organized tissue extends farther into rostral occipitotemporal cortex of the monkey than generally assumed. PMID:25080580

  7. Evidence for Non-Opponent Coding of Colour Information in Human Visual Cortex: Selective Loss of "Green" Sensitivity in a Subject with Damaged Ventral Occipito-Temporal Cortex.

    PubMed

    Rauscher, Franziska G; Plant, Gordon T; James-Galton, Merle; Barbur, John L

    2011-01-01

    Damage to ventral occipito-temporal extrastriate visual cortex leads to the syndrome of prosopagnosia often with coexisting cerebral achromatopsia. A patient with this syndrome resulting in a left upper homonymous quadrantanopia, prosopagnosia, and incomplete achromatopsia is described. Chromatic sensitivity was assessed at a number of locations in the intact visual field using a dynamic luminance contrast masking technique that isolates the use of colour signals. In normal subjects chromatic detection thresholds form an elliptical contour when plotted in the Commission Internationale d'Eclairage, (x-y), chromaticity diagram. Because the extraction of colour signals in early visual processing involves opponent mechanisms, subjects with Daltonism (congenital red/green loss of sensitivity) show symmetric increase in thresholds towards the long wavelength ("red") and middle wavelength ("green") regions of the spectrum locus. This is also the case with acquired loss of chromatic sensitivity as a result of retinal or optic nerve disease. Our patient's results were an exception to this rule. Whilst his chromatic sensitivity in the central region of the visual field was reduced symmetrically for both "red/green" and "yellow/blue" directions in colour space, the subject's lower left quadrant showed a marked asymmetry in "red/green" thresholds with the greatest loss of sensitivity towards the "green" region of the spectrum locus. This spatially localized asymmetric loss of "green" but not "red" sensitivity has not been reported previously in human vision. Such loss is consistent with selective damage of neural substrates in the visual cortex that process colour information, but are spectrally non-opponent.

  8. White Light Sagnac Interferometer for Snapshot Multispectral Imaging (Preprint)

    DTIC Science & Technology

    2009-01-01

    normalized difference vegetation index ( NDVI ) provided in Fig. 12 (b). The NDVI is calculated by ( ) ( ) ( )( ) ( ) , ,2 , ,3 , , ,2 , ,3 I l n I l n NDVI ... NDVI . Conversely, if the leaf has little to no chlorophyll, order 3 will have nearly equal reflected energy compared to order 2, yielding a low NDVI ...This is observed in the NDVI image, where the upper left portion of the scene (quadrant 2) contains the unhealthy leaf, while the lower right region

  9. [Choledocholithiasis and pregnancy. Hybrid laparo-endoscopic treatment in one step].

    PubMed

    Valadez-Caballero, David; González-Santamaría, Roberto; Soto-Mendoza, Héctor; Alberto Blanco-Figueroa, Jorge; Flores-Pantoja, Juan Manuel

    2014-01-01

    Complications associated with choledocholithiasis are uncommon during pregnancy. However, when it occurs, the morbidity and mortality related for the product and the mother increases, so a proper treatment is imperative in these patients. A 25-year-old pregnant woman on her second trimester. The current condition was started four days prior to the hospital admission with abdominal pain in the right upper quadrant with nausea and vomit.Twenty-four hours later jaundice and dark urine is observed. Physical examination shows scleral jaundice, right upper quadrant abdominal pain without peritoneal irritation. Uterus at umbilicus level without uterine activity. Uterus at umbilicus level without uterine activity. Laboratory tests showed elevated bilirubin and transaminases without leukocytosis; ultrasound reported live intrauterine unique product, with a heart rate of 128 beats per minute, gallbladder with multiple images inside that cast acoustic shadowing, and a 10 mm common bile duct dilated bile duct with dilatation of intrahepatic bile ducts. It was perform laparoscopic cholecystectomy with intraoperative cholangiography and placement of a transcystic jaguar guide for selective cannulation of the common bile duct. Intraoperative endoscopic retrograde cholangiopancreatography was performed with endoscopic stone extraction. The outcome was satisfactory with a hospital discharge at 48 hours. Current evidence has shown that the combined use of laparoscopy and therapeutic endoscopic cholangiography in one step is effective for the treatment of choledocholithiasis, decreasing the risk of complications associated with cannulation of the bile duct.

  10. Splenic Infarction in Acute Infectious Mononucleosis.

    PubMed

    Naviglio, Samuele; Abate, Maria Valentina; Chinello, Matteo; Ventura, Alessandro

    2016-01-01

    The evaluation of a febrile patient with acute abdominal pain represents a frequent yet possibly challenging situation in the emergency department (ED). Splenic infarction is an uncommon complication of infectious mononucleosis, and may have a wide range of clinical presentations, from dramatic to more subtle. Its pathogenesis is still incompletely understood, yet it may be associated with the occurrence of transient prothrombotic factors. We report the case of a 14-year-old boy who presented with fever, sore throat, left upper quadrant abdominal pain, and splenomegaly, with no history of recent trauma. Laboratory tests revealed a markedly prolonged activated partial thromboplastin time and positive lupus anticoagulant. Abdominal ultrasonography showed several hypoechoic areas in the spleen consistent with multiple infarctions. Magnetic resonance imaging eventually confirmed the diagnosis. He was admitted for observation and supportive treatment, and was discharged in good condition after 7 days. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Spontaneous splenic infarction should be considered in the differential list of patients presenting with left upper quadrant abdominal pain and features of infectious mononucleosis; the diagnosis, however, may not be straightforward, as clinical presentation may also be subtle, and abdominal ultrasonography, which is often used as a first-line imaging modality in pediatric EDs, has low sensitivity in this scenario and may easily miss it. Furthermore, although treatment is mainly supportive, close observation for possible complications is necessary. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. The association between postural alignment and psychosocial factors to upper quadrant pain in high school students: a prospective study.

    PubMed

    Brink, Yolandi; Crous, Lynette Christine; Louw, Quinette Abigail; Grimmer-Somers, Karen; Schreve, Kristiaan

    2009-12-01

    Prolonged sitting and psychosocial factors have been associated with musculoskeletal symptoms among adolescents. However, the impact of prolonged static sitting on musculoskeletal pain among South African high school students is uncertain. A prospective observational study was performed to determine whether sitting postural alignment and psychosocial factors contribute to the development of upper quadrant musculoskeletal pain (UQMP) in grade ten high school students working on desktop computers. The sitting postural alignment, depression, anxiety and computer use of 104 asymptomatic students were measured at baseline. At three and six months post baseline, the prevalence of UQMP was determined. Twenty-seven students developed UQMP due to seated or computer-related activities. An extreme cervical angle (<34.75 degrees or >43.95 degrees; OR 2.8; 95% CI: 1.1-7.3) and a combination of extreme cervical and thoracic angles (<63.1 degrees or >71.1 degrees; OR 2.2; 95% CI: 1.1-5.6) were significant postural risk factors for the development of UQMP. Boys with any extreme angle were more likely to suffer pain compared with boys with all middle range angles (OR 4.9; 95% CI: 1.0-24.5). No similar effect was found for girls. There was no strong relationship between depression, anxiety, computer exposure and UQMP among South African high school students.

  12. Training improves reading speed in peripheral vision: is it due to attention?

    PubMed

    Lee, Hye-Won; Kwon, Miyoung; Legge, Gordon E; Gefroh, Joshua J

    2010-06-01

    Previous research has shown that perceptual training in peripheral vision, using a letter-recognition task, increases reading speed and letter recognition (S. T. L. Chung, G. E. Legge, & S. H. Cheung, 2004). We tested the hypothesis that enhanced deployment of spatial attention to peripheral vision explains this training effect. Subjects were pre- and post-tested with 3 tasks at 10° above and below fixation-RSVP reading speed, trigram letter recognition (used to construct visual-span profiles), and deployment of spatial attention (measured as the benefit of a pre-cue for target position in a lexical-decision task). Groups of five normally sighted young adults received 4 days of trigram letter-recognition training in upper or lower visual fields, or central vision. A control group received no training. Our measure of deployment of spatial attention revealed visual-field anisotropies; better deployment of attention in the lower field than the upper, and in the lower-right quadrant compared with the other three quadrants. All subject groups exhibited slight improvement in deployment of spatial attention to peripheral vision in the post-test, but this improvement was not correlated with training-related increases in reading speed and the size of visual-span profiles. Our results indicate that improved deployment of spatial attention to peripheral vision does not account for improved reading speed and letter recognition in peripheral vision.

  13. ACUTE CHOLECYSTITIS AS AN UNUSUAL PRESENTATION OF SCRUB TYPHUS: A REPORT OF TWO CASES AND REVIEW OF THE LITERATURE.

    PubMed

    Charoenphak, Sirima; Rattanawong, Pattara; Sungkanuparph, Somnuek

    2017-01-01

    Scrub typhus rarely presents with acute cholecystitis. We present 2 cases of scrub typhus with cholecystitis. The first patient is a 62 year old female who presented to the hospital with fever and body aches for 1 week and right upper quadrant abdominal pain for 3 days. She gave a history of an insect bite 2 weeks previously. She was diagnosed as having acute cholecystitis and underwent cholecystectomy. She continued with fever post-operatively and physical examination revealed an eschar. She had an immunofluorescence assay (IFA) performed that revealed a high IgM titer for Orientia tsutsugamushi. She was diagnosed as having scrub typhus, treated with doxycycline and she recovered completely. The second patient also presented to the hospital with a 1 week history of fever and upper quadrant abdominal pain. She was diagnosed with having cholecystitis. Her symptoms did not improve with intravenous antibiotics and further investigation revealed elevated titers for O. tsutsugamushi and Leptospira interrogans. She was diagnosed as having a co-infection of scrub typhus and leptospirosis and treated with doxycycline. She recovered completely. Patients from scrub typhus endemic regions who present with acute cholecystitis but do not respond to traditional treatment should be tested for scrub typhus and leptospirosis and should have a careful admission physical examination looking for eschar formation, since scrub typhus may present with acute cholecystitis.

  14. In vivo imaging of palisades of Vogt in dry eye versus normal subjects using en-face spectral-domain optical coherence tomography

    PubMed Central

    Djerada, Zoubir; Liang, Hong; El Sanharawi, Mohamed; Labbé, Antoine; Baudouin, Christophe

    2017-01-01

    Purpose To evaluate a possible clinical application of spectral-domain optical coherence tomography (SD-OCT) using en-face module for the imaging of the corneoscleral limbus in normal subjects and dry eye patients. Patients and methods Seventy-six subjects were included in this study. Seventy eyes of 35 consecutive patients with dry eye disease and 82 eyes of 41 healthy control subjects were investigated. All subjects were examined with the Avanti RTVue® anterior segment OCT. En-face OCT images of the corneoscleral limbus were acquired in four quadrants (inferior, superior, nasal and temporal) and then were analyzed semi-quantitatively according to whether or not palisades of Vogt (POV) were visible. En-face OCT images were then compared to in vivo confocal microscopy (IVCM) in eleven eyes of 7 healthy and dry eye patients. Results En-face SD-OCT showed POV as a radially oriented network, located in superficial corneoscleral limbus, with a good correlation with IVCM features. It provided an easy and reproducible identification of POV without any special preparation or any direct contact, with a grading scale from 0 (no visualization) to 3 (high visualization). The POV were found predominantly in superior (P<0.001) and inferior (P<0.001) quadrants when compared to the nasal and temporal quadrants for all subjects examined. The visibility score decreased with age (P<0.001) and was lower in dry eye patients (P<0.01). In addition, the score decreased in accordance with the severity of dry eye disease (P<0.001). Conclusion En-face SD-OCT is a non-contact imaging technique that can be used to evaluate the POV, thus providing valuable information about differences in the limbal anatomy of dry eye patients as compared to healthy patients. PMID:29176786

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

    Ginsburg, A.; Bally, J.; Battersby, C.

    We search the {lambda} = 1.1 mm Bolocam Galactic Plane Survey for clumps containing sufficient mass to form {approx}10{sup 4} M{sub Sun} star clusters. Eighteen candidate massive proto-clusters are identified in the first Galactic quadrant outside of the central kiloparsec. This sample is complete to clumps with mass M{sub clump} > 10{sup 4} M{sub Sun} and radius r {approx}< 2.5 pc. The overall Galactic massive cluster formation rate is CFR(M{sub cluster} > 10{sup 4}) {approx}<5 Myr{sup -1}, which is in agreement with the rates inferred from Galactic open clusters and M31 massive clusters. We find that all massive proto-clusters inmore » the first quadrant are actively forming massive stars and place an upper limit of {tau}{sub starless} < 0.5 Myr on the lifetime of the starless phase of massive cluster formation. If massive clusters go through a starless phase with all of their mass in a single clump, the lifetime of this phase is very short.« less

  16. Identification of temporal pathomechanical factors during the tennis serve.

    PubMed

    Martin, Caroline; Kulpa, Richard; Ropars, Mickaël; Delamarche, Paul; Bideau, Benoit

    2013-11-01

    The purpose of this study was twofold: (a) to measure the effects of temporal parameters on both ball velocity and upper limb joint kinetics to identify pathomechanical factors during the tennis serve and (b) to validate these pathomechanical factors by comparing injured and noninjured players. The serves of expert tennis players were recorded with an optoelectronic motion capture system. These experts were then followed during two seasons to identify overuse injuries of the upper limb. Correlation coefficients assessed the relationships between temporal parameters, ball velocity, and peaks of upper limb joint kinetics to identify pathomechanical factors. Temporal parameters and ball velocity were compared between injured and noninjured groups. Temporal pathomechanical factors were identified. The timings of peak angular velocities of pelvis longitudinal rotation, upper torso longitudinal rotation, trunk sagittal rotation, and trunk transverse rotation and the duration between instants of shoulder horizontal adduction and external rotation were significantly related to upper limb joint kinetics and ball velocity. Injured players demonstrated later timings of trunk rotations, improper differences in time between instants of shoulder horizontal adduction and external rotation, lower ball velocities, and higher joint kinetics. The findings of this study imply that improper temporal mechanics during the tennis serve can decrease ball velocity, increase upper limb joint kinetics, and thus possibly increase overuse injuries of the upper limb.

  17. Splenic infarction as a rare complication of infectious mononucleosis due to Epstein-Barr virus infection in a patient with no significant comorbidity: case report and review of the literature.

    PubMed

    Gavriilaki, Eleni; Sabanis, Nikolaos; Paschou, Eleni; Grigoriadis, Savas; Mainou, Maria; Gaitanaki, Alexandra; Skargani-Koraka, Maria

    2013-11-01

    We report the case of a 17-y-old boy diagnosed with infectious mononucleosis due to Epstein-Barr virus infection who complained of left upper quadrant pain. A magnetic resonance imaging scan showed a splenic infarct in the enlarged spleen. Other causes of splenic infarction were excluded. Thus, infectious mononucleosis may cause splenic infarction in patients without other comorbidities.

  18. Earth observations of a sunrise / sunset taken during the Expedition Three mission

    NASA Image and Video Library

    2001-11-04

    ISS003-E-7559 (4 November 2001) --- Pictured near Earth's horizon, Hurricane Michelle made landfall on Cuba a few hours later on November 4, 2001, with sustained winds of 135 miles per hour. The eye can be seen in the upper right quadrant of this oblique view. The most signficant impact was in the Matanzas province near Pinar del Rio. This scene was captured by one of the Expedition Three crew members aboard the International Space Station (ISS)using a digital still camera.

  19. Ring down artefacts on abdominal sonography to predict pulmonary abnormalities in the emergency department.

    PubMed

    Tsai, C-L; Wang, H-P; Lien, W-C; Chen, C-C; Lai, T-I; Chen, W-J

    2005-10-01

    Ring down artefacts are sometimes found when emergency physicians perform abdominal ultrasound to differentiate between various abdominal problems. We describe a patient who presented with right upper quadrant abdominal pain and whose ultrasound examination showed ring down artefacts posterior to the right hemidiaphragm, which led to the eventual diagnosis of pneumonia. Ring down artefacts on ultrasound may be used to predict pulmonary abnormalities. Awareness of this sonographic finding may assist in accurate diagnosis and administration of appropriate treatment without delay.

  20. Tokyo, Yokohama and Tokoy Bay as seen from STS-58

    NASA Image and Video Library

    1993-10-30

    STS058-103-080 (18 Oct-1 Nov 1993) --- Japan's modern megalopolis is seen in this nadir view in great detail. More than 80 vessels can be seen at the anchorage's in Tokyo Bay. The gardens of the Emperor's Palace are seen in this circular area in the upper left quadrant. Even greater detail of this area was captured in the simultaneous color infrared image acquired during this space shuttle mission. (That photo number is STS058-110-085.)

  1. Saccades to a remembered location elicit spatially-specific activation in human retinotopic visual cortex

    PubMed Central

    Geng, Joy J.; Ruff, Christian C.; Driver, Jon

    2008-01-01

    The possible impact upon human visual cortex from saccades to remembered target locations was investigated using fMRI. A specific location in the upper-right or upper-left visual quadrant served as the saccadic target. After a delay of 2400 msecs, an auditory signal indicated whether to execute a saccade to that location (go trial) or to cancel the saccade and remain centrally fixated (no-go). Group fMRI analysis revealed activation specific to the remembered target location for executed saccades, in contralateral lingual gyrus. No-go trials produced similar, albeit significantly reduced effects. Individual retinotopic mapping confirmed that on go trials, quadrant-specific activations arose in those parts of ventral V1, V2, and V3 that coded the target location for the saccade, whereas on no-go trials only the corresponding parts of V2 and V3 were significantly activated. These results indicate that a spatial-motor saccadic task (i.e. making an eye-movement to a remembered location) is sufficient to activate retinotopic visual cortex spatially corresponding to the target location, and that this activation is also present (though reduced) when no saccade is executed. We discuss the implications of finding that saccades to remembered locations can affect early visual cortex, not just those structures conventionally associated with eye-movements, in relation to recent ideas about attention, spatial working memory, and the notion that recently activated representations can be ‘refreshed’ when needed. PMID:18510442

  2. Left-sided appendicitis: review of 95 published cases and a case report.

    PubMed

    Akbulut, Sami; Ulku, Abdullah; Senol, Ayhan; Tas, Mahmut; Yagmur, Yusuf

    2010-11-28

    To give an overview of the literature on left-sided acute appendicitis (LSAA) associated with situs inversus totalis (SIT) and midgut malrotation (MM). We present a new case of LSAA with SIT and a literature review of studies published in the English language on LSAA, accessed via PubMed and Google Scholar databases. Ninety-five published cases of LSAA were evaluated and a 25-year-old female, who presented to our clinic with left lower abdominal pain caused by LSAA, is reported. In the reviewed literature, fifty-seven patients were male and 38 were female with an age range of 8 to 82 years and a median age of 29.1 ± 15.9 years. Sixty-six patients had SIT, 23 had MM, three had cecal malrotation, and two had a previously unnoted congenital abnormality. Fifty-nine patients had presented to the hospital with left lower, 14 with right lower and seven with bilateral lower quadrant pain, and seven subjects complained of left upper quadrant pain. The diagnosis was established preoperatively in 49 patients, intraoperatively in 19, and during the postoperative period in five; 14 patients were aware of having this anomaly. The data of eight patients were not unavailable. Eleven patients underwent laparoscopic appendectomy, which was combined with cholecystectomy in two cases. Histopathological examination of the appendix specimens revealed adenocarcinoma in only two of 95 patients. The diagnosis of left lower quadrant pain is based on well-established clinical symptoms, physical examination and physician's experience.

  3. Concordance between peri-areolar blue dye and peri-incisional radiotracer injections for sentinel node mapping in patients with a history of primary breast cancer excisonal biopsy.

    PubMed

    Mehrabibahar, M; Azizi, S; Jangjoo, A; Saremi, E; Kakhki, V R Dabbagh; Sadeghi, R; Chicken, D W; Keshtgar, M

    2014-01-01

    We evaluated the concordance between peri-areolar blue dye and peri-incisional radiotracer injections for axillary sentinel node mapping of patients with the history of previous breast lesion excisional biopsy. 80 patients with the history of previous excisional biopsy of the breast lesions were included. All patients received two injections of 99mTc-antimony sulfide colloid in both ends of incision line in an intradermal fashion. 2 mL patient blue V dye was injection to all patients in the peri-areolar area of the index quadrant after induction of anesthesia. All blue or hot nodes were harvested as sentinel lymph nodes. At least one sentinel node could be detected during surgery in 79 patients. In total 94 sentinel nodes were detected. All detected sentinel nodes were hot. In three patients sentinel nodes were detected by gamma probe but not blue dye. The tumor location in all of these patients was in the upper lateral quadrant and the incision line was extended into the axillary tail of the breast in all of them. 91 out of 94 sentinel nodes were stained blue, which amounts to 95.8% concordance between blue dye and radiotracer on a per node analysis. Single peri-areolar injection in the index quadrant would suffice for sentinel node mapping of patients with history of excisional biopsy. Care should be taken in patients with large excisional biopsy in the extreme proximity to axilla.

  4. Impaired temporal, not just spatial, resolution in amblyopia.

    PubMed

    Spang, Karoline; Fahle, Manfred

    2009-11-01

    In amblyopia, neuronal deficits deteriorate spatial vision including visual acuity, possibly because of a lack of use-dependent fine-tuning of afferents to the visual cortex during infancy; but temporal processing may deteriorate as well. Temporal, rather than spatial, resolution was investigated in patients with amblyopia by means of a task based on time-defined figure-ground segregation. Patients had to indicate the quadrant of the visual field where a purely time-defined square appeared. The results showed a clear decrease in temporal resolution of patients' amblyopic eyes compared with the dominant eyes in this task. The extent of this decrease in figure-ground segregation based on time of motion onset only loosely correlated with the decrease in spatial resolution and spanned a smaller range than did the spatial loss. Control experiments with artificially induced blur in normal observers confirmed that the decrease in temporal resolution was not simply due to the acuity loss. Amblyopia not only decreases spatial resolution, but also temporal factors such as time-based figure-ground segregation, even at high stimulus contrasts. This finding suggests that the realm of neuronal processes that may be disturbed in amblyopia is larger than originally thought.

  5. Optimal time following fluorescein instillation to evaluate rigid gas permeable contact lens fit.

    PubMed

    Wolffsohn, James S; Tharoo, Ali; Lakhlani, Nikita

    2015-04-01

    To examine the optimum time at which fluorescein patterns of gas permeable lenses (GPs) should be evaluated. Aligned, 0.2mm steep and 0.2mm flat GPs were fitted to 17 patients (aged 20.6 ± 1.1 years, 10 male). Fluorescein was applied to their upper temporal bulbar conjunctiva with a moistened fluorescein strip. Digital slit lamp images (CSO, Italy) at 10× magnification of the fluorescein pattern viewed with blue light through a yellow filter were captured every 15s. Fluorescein intensity in central, mid peripheral and edge regions of the superior, inferior, temporal and nasal quadrants of the lens were graded subjectively using a +2 to -2 scale and using ImageJ software on the simultaneously captured images. Subjectively graded and objectively image analysed fluorescein intensity changed with time (p < 0.001), lens region (centre, mid-periphery and edge: p < 0.05) and there was interaction between lens region with lens fit (p < 0.001). For edge band width, there was a significant effect of time (F = 118.503, p < 0.001) and lens fit (F = 5.1249, p = 0.012). The expected alignment, flat and steep fitting patterns could be seen from approximately after 30 to 180 s subjectively and 15 to 105 s in captured images. Although the stability of fluorescein intensity can start to decline in as little as 45 s post fluorescein instillation, the diagnostic pattern of alignment, steep or flat fit is seen in each meridian by subjective observation from about 30s to 3 min indicating this is the most appropriate time window to evaluate GP lenses in clinical practice. Copyright © 2014 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  6. Evidence for Non-Opponent Coding of Colour Information in Human Visual Cortex: Selective Loss of “Green” Sensitivity in a Subject with Damaged Ventral Occipito-Temporal Cortex

    PubMed Central

    Rauscher, Franziska G.; Plant, Gordon T.; James-Galton, Merle; Barbur, John L.

    2011-01-01

    Damage to ventral occipito-temporal extrastriate visual cortex leads to the syndrome of prosopagnosia often with coexisting cerebral achromatopsia. A patient with this syndrome resulting in a left upper homonymous quadrantanopia, prosopagnosia, and incomplete achromatopsia is described. Chromatic sensitivity was assessed at a number of locations in the intact visual field using a dynamic luminance contrast masking technique that isolates the use of colour signals. In normal subjects chromatic detection thresholds form an elliptical contour when plotted in the Commission Internationale d’Eclairage, (x-y), chromaticity diagram. Because the extraction of colour signals in early visual processing involves opponent mechanisms, subjects with Daltonism (congenital red/green loss of sensitivity) show symmetric increase in thresholds towards the long wavelength (“red”) and middle wavelength (“green”) regions of the spectrum locus. This is also the case with acquired loss of chromatic sensitivity as a result of retinal or optic nerve disease. Our patient’s results were an exception to this rule. Whilst his chromatic sensitivity in the central region of the visual field was reduced symmetrically for both “red/green” and “yellow/blue” directions in colour space, the subject’s lower left quadrant showed a marked asymmetry in “red/green” thresholds with the greatest loss of sensitivity towards the “green” region of the spectrum locus. This spatially localized asymmetric loss of “green” but not “red” sensitivity has not been reported previously in human vision. Such loss is consistent with selective damage of neural substrates in the visual cortex that process colour information, but are spectrally non-opponent. PMID:27956924

  7. A cross-sectional analysis of the prevalence of tooth agenesis and structural dental anomalies in association with cleft type in non-syndromic oral cleft patients.

    PubMed

    Konstantonis, Dimitrios; Alexandropoulos, Alexandros; Konstantoni, Nikoleta; Nassika, Maria

    2017-12-01

    The aim of this study was to investigate the prevalence of tooth agenesis, microdontia, and tooth malformation among non-syndromic oral cleft patients and their potential association with cleft type and gender. Intraoral records and radiographs of 154 patients (97 males and 57 females) were examined. The variables assessed were tooth agenesis, microdontia, dental malformations, and cleft types. The statistics included chi-square and Fisher's exact tests as well as logistic regression to assess any mutual effects of gender and cleft type on the dental variables. Tooth agenesis occurred in 50% of the sample and microdontia in 18%. Non-statistically significant odds ratios for the association of gender and cleft type with tooth agenesis were obtained. Tooth agenesis was substantially higher at the unilateral right CL + P and the bilateral CL + P in quadrant 1 and at the unilateral left CL + P and bilateral CL + P in quadrant 2. It was also higher, at the isolated cleft palate (CP) in quadrants 3 and 4. These results were attributed to teeth 22 (31.8%) and 12 (21.6%) in the maxilla and to teeth 35 (6.1%) and 45 (5.4%) in the mandible. In unilateral CL + P patients, the cleft quadrant that presented tooth agenesis was associated with the side of the cleft. Interdisciplinary treatment of the oral cleft patients should take into consideration the high prevalence of tooth agenesis and their association with the different cleft types. The most frequently affected teeth by cleft are by far the upper lateral incisors. Results indicate that tooth agenesis appears to be a genetically controlled anomaly related to the orofacial cleft development through various genetic links and not caused by the cleft disruptive process.

  8. Skin Dosimetry in Breast Teletherapy on a Phantom Anthropomorphic and Anthropometric Phantom

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

    Batista Nogueira, Luciana; Lemos Silva, Hugo Leonardo; Donato da Silva, Sabrina

    This paper addresses the breast teletherapy dosimetry. The goal is to evaluate and compare absorbed doses in equivalent skin tissue, TE-skin, of an anthropomorphic and anthropometric breast phantom submitted to breast radiotherapy. The methodology involved the reproduction of a set of tomographic images of the phantom; the elaboration of conformational radiotherapy planning in the SOMAVISION and CadPlan (TPS) software; and the synthetic breast irradiation by parallel opposed fields in 3D conformal teletherapy at 6 MV linear accelerator Clinac-2100 C from VARIAN with prescribed dose (PD) of 180 cGy to the target volume (PTV), referent to the glandular tissue. Radiochromic filmsmore » EBT2 were selected as dosimeters. Two independent calibration processes of films with solid water Gammex 457 plates and water filled box were produced. Curves of optical density (OD) versus absorbed dose were produced. Dosimeters were positioned in the external region of the breast phantom in contact with TE-skin, area of 4.0 cm{sup 2} each. The irradiation process was prepared in duplicate to check the reproducibility of the technique. The radiochromic films were scanned and their response in RGB (Red, Green, Blue) analyzed by the ImageJ software. The optical density was obtained and converted to dose based on the calibration curves. Thus, the spatial dose distribution in the skin was reproduced. The absorbed doses measured on the radiochromic films in TE-skin showed values between upper and lower quadrants at 9 o'clock in the range of 54% of PD, between the upper and lower quadrants 3 o'clock in the range of 72% and 6 o'clock at the lower quadrant in the range of 68 % of PD. The values are ±64% (p <0.05) according to the TPS. It is concluded that the depth dose measured in solid water plates or water box reproduce equivalent dose values for both calibration processes of the radiochromic films. It was observed that the skin received doses ranging from 50% to 78% of the prescribed dose after two parallel opposed irradiation fields. (authors)« less

  9. Giant kidney worm (Dioctophyma renale) infection mimicking retroperitoneal neoplasm.

    PubMed

    Sun, T; Turnbull, A; Lieberman, P H; Sternberg, S S

    1986-07-01

    A 50-year-old Chinese man was found by ultrasound and computed tomography to have a retroperitoneal mass in the right upper quadrant of the abdomen. At operation, a hemorrhagic cyst was detected at the upper pole of the right kidney adjacent to the adrenal gland. Microscopic examination revealed that the cyst wall was composed of granulomatous tissue loaded with eggs and cross-sections of parasites, identified as Dioctophyma renale. The eggs were characterized by a birefringent striated double wall. The presence of cross sections of adult worms of D. renale in human tissue has not been previously described. Another unique feature of this case was that the right kidney was intact, as examined grossly at laparotomy and by intravenous pyelography. Eggs were not detected in the urine.

  10. [Acute right-sided upper abdominal pain in a 46-year-old woman].

    PubMed

    Bauder, M; Fiala, A; Klinger, C; Kersjes, W; Caca, K

    2018-02-01

    A 46-year-old woman presented with acute abdominal pain in the right upper quadrant. Esophagogastroduodenoscopy revealed a duodenal stenosis within the horizontal part of the duodenum. Based on the findings of abdominal computed tomography (CT), endosonography, Doppler duplex sonography and angiography, the diagnosis of an aneurysm of a branch of the inferior pancreaticoduodenal artery was established. This arterial branch was part of a collateral circulation between the superior mesenteric artery and the proper hepatic artery caused by obturation of the celiac artery. The symptomatic duodenal stenosis was the result of a local hematoma due to prior rupture of an aneurysm. After successful coiling of the afferent vessels to the aneurysm follow-up examinations showed progredient resorption of the hematoma and the patient was free of complaints.

  11. Houston/Galveston, Texas, USA

    NASA Image and Video Library

    1991-05-06

    STS039-151-175 (28 April-6 May 1991) --- Large format (five-inch) frame of part of the greater Houston metropolitan area photographed from the Earth-orbiting Space Shuttle Discovery. (Hold photo vertically with Galveston at bottom so that north will be at top.) Heavier than normal spring rains emphasize the several bodies of water in the area. Thanks to Sun angle, the interstate highways, Houston's belt and loop systems and even city streets, farm-to-market roads and airport runways are easily observed in the frame. NASA and Clear Lake City, work and home areas of the seven Discovery astronaut crew members, are easily spotted near upper Galveston Bay in bottom (south portion) of the frame. Houston's central business district and the Harris County Domed Stadium are seen in the upper left quadrant.

  12. Subperiosteal lateral browlift and its relationship to upper blepharoplasty.

    PubMed

    Gasperoni, C; Salgarello, M; Gargani, G

    1993-01-01

    Skin redundancy of the upper eyelid is often associated with a variable degree of ptosis of the lateral third of the eyebrow, which increases the extent of the defect. Correcting this condition implies a combination of a temporal lift with a standard upper blepharoplasty. In the temporal lift it is possible to perform an easy subaponeurotic and subperiosteal dissection of the soft tissues of the temporal area through an incision behind the hairline with pleasing and long-lasting results. The brow ptosis is corrected without noticeable scars and with inconspicuous damage to scalp follicles of the temporal region.

  13. 50. VIEW OF CRUSHER ADDITION FROM EAST. SHOWS 100TON STEEL ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    50. VIEW OF CRUSHER ADDITION FROM EAST. SHOWS 100-TON STEEL UNOXIDIZED ORE BIN, STEPHENS-ADAMSON 15 TON/HR INCLINED BUCKET ELEVATOR, AND DUST COLLECTION BIN IN UPPER RIGHT QUADRANT. THE ROD MILL CIRCUIT STOOD IN FRONT OF THE BUCKET ELEVATOR AND BEHIND THE BAKER COOLER (LEFT CENTER). MILL SOLUTION TANKS WERE IN FRONT OF THE CRUSHED OXIDIZED ORE BIN (CENTER), AND THE MILL FLOOR WAS THE NEXT LEVEL DOWN (RIGHT). - Bald Mountain Gold Mill, Nevada Gulch at head of False Bottom Creek, Lead, Lawrence County, SD

  14. EVA 5 activity on Flight Day 8 to service the Hubble Space Telescope

    NASA Image and Video Library

    1997-02-18

    S82-E-5718 (18 Feb. 1997) --- Making use of the Remote Manipulator System (RMS) astronauts Mark C. Lee (left), STS-82 payload commander, and Steven L. Smith, mission specialist, perform the final phases of Extravehicular Activity (EVA) duty. Lee holds a patch piece for Bay #10, out of view, toward which the two were headed. A sample of the patch work can be seen on Bay #9 in the upper left quadrant of the picture. This view was taken with an Electronic Still Camera (ESC).

  15. Optical Coherence Tomography in Alzheimer's Disease: A Meta-Analysis.

    PubMed

    Coppola, Gianluca; Di Renzo, Antonio; Ziccardi, Lucia; Martelli, Francesco; Fadda, Antonello; Manni, Gianluca; Barboni, Piero; Pierelli, Francesco; Sadun, Alfredo A; Parisi, Vincenzo

    2015-01-01

    Alzheimer's disease (AD) is a neurodegenerative disorder, which is likely to start as mild cognitive impairment (MCI) several years before the its full-blown clinical manifestation. Optical coherence tomography (OCT) has been used to detect a loss in peripapillary retina nerve fiber layer (RNFL) and a reduction in macular thickness and volume of people affected by MCI or AD. Here, we performed an aggregate meta-analysis combining results from different studies. Data sources were case-control studies published between January 2001 and August 2014 (identified through PubMed and Google Scholar databases) that examined the RNFL thickness by means of OCT in AD and MCI patients compared with cognitively healthy controls. 11 studies were identified, including 380 patients with AD, 68 with MCI and 293 healthy controls (HC). The studies suggest that the mean RNFL thickness is reduced in MCI (weighted mean differences in μm, WMD = -13.39, 95% CI: -17.34 to -9.45, p = 0.031) and, even more so, in AD (WMD = -15.95, 95% CI: -21.65 to -10.21, p<0.0001) patients compared to HC. RNFL in the 4 quadrants were all significantly thinner in AD superior (superior WMD = -24.0, 95% CI: -34.9 to -13.1, p<0.0001; inferior WMD = -20.8, 95% CI: -32.0 to -9.7, p<0.0001; nasal WMD = -14.7, 95% CI: -23.9 to -5.5, p<0.0001; and temporal WMD = -10.7, 95% CI: -19.9 to -1.4, p<0.0001); the same significant reduction in quadrant RNFL was observed in MCI patients compared with HC (Inferior WMD = -20.22, 95% CI: -30.41 to -10.03, p = 0.0001; nasal WMD = -7.4, 95% CI: -10.08 to -4.7, p = 0.0000; and temporal WMD = -6.88, 95% CI: -12.62 to -1.13, p = 0.01), with the exception of superior quadrant (WMD = -19.45, 95% CI: -40.23 to 1.32, p = 0.06). Results from the meta-analysis support the important role of OCT for RNFL analysis in monitoring the progression of AD and in assessing the effectiveness of purported AD treatments.

  16. Accuracy and Reliability of Eye-Based vs Quadrant-Based Diagnosis of Plus Disease in Retinopathy of Prematurity.

    PubMed

    Kim, Sang Jin; Campbell, J Peter; Kalpathy-Cramer, Jayashree; Ostmo, Susan; Jonas, Karyn E; Choi, Dongseok; Chan, R V Paul; Chiang, Michael F

    2018-06-01

    Presence of plus disease in retinopathy of prematurity is the most critical element in identifying treatment-requiring disease. However, there is significant variability in plus disease diagnosis. In particular, plus disease has been defined as 2 or more quadrants of vascular abnormality, and it is not clear whether it is more reliably and accurately diagnosed by eye-based assessment of overall retinal appearance or by quadrant-based assessment combining grades of 4 individual quadrants. To compare eye-based vs quadrant-based diagnosis of plus disease and to provide insight for ophthalmologists about the diagnostic process. In this multicenter cohort study, we developed a database of 197 wide-angle retinal images from 141 preterm infants from neonatal intensive care units at 9 academic institutions (enrolled from July 2011 to December 2016). Each image was assigned a reference standard diagnosis based on consensus image-based and clinical diagnosis. Data analysis was performed from February 2017 to September 2017. Six graders independently diagnosed each of the 4 quadrants (cropped images) of the 197 eyes (quadrant-based diagnosis) as well as the entire image (eye-based diagnosis). Images were displayed individually, in random order. Quadrant-based diagnosis of plus disease was made when 2 or more quadrants were diagnosed as indicating plus disease by combining grades of individual quadrants post hoc. Intragrader and intergrader reliability (absolute agreement and κ statistic) and accuracy compared with the reference standard diagnosis. Of the 141 included preterm infants, 65 (46.1%) were female and 116 (82.3%) white, and the mean (SD) gestational age was 27.0 (2.6) weeks. There was variable agreement between eye-based and quadrant-based diagnosis among the 6 graders (Cohen κ range, 0.32-0.75). Four graders showed underdiagnosis of plus disease with quadrant-based diagnosis compared with eye-based diagnosis (by McNemar test). Intergrader agreement of quadrant-based diagnosis was lower than that of eye-based diagnosis (Fleiss κ, 0.75 [95% CI, 0.71-0.78] vs 0.55 [95% CI, 0.51-0.59]). The accuracy of eye-based diagnosis compared with the reference standard diagnosis was substantial to near-perfect, whereas that of quadrant-based plus disease diagnosis was only moderate to substantial for each grader. Graders had lower reliability and accuracy using quadrant-based diagnosis combining grades of individual quadrants than with eye-based diagnosis, suggesting that eye-based diagnosis has advantages over quadrant-based diagnosis. This has implications for more precise definitions of plus disease regarding the criterion of 2 or more quadrants, clinical care, computer-based image analysis, and education for all ophthalmologists who manage retinopathy of prematurity.

  17. EFFECT OF INTENSE FUNCTIONAL TASK TRAINING UPON TEMPORAL STRUCTURE OF VARIABILITY OF UPPER EXTREMITY POST STROKE

    PubMed Central

    Sethi, Amit; Davis, Sandra; McGuirk, Theresa; Patterson, Tara S.; Richards, Lorie G.

    2012-01-01

    Study Design Quasi-experimental design Introduction Although the effectiveness of constraint induced movement therapy (CIMT) in upper extremity (UE) rehabilitation post stroke is well known, the efficacy of CIMT to enhance the temporal structure of variability in upper extremity movement is not known. Purpose The purpose of this study was to investigate whether CIMT could enhance temporal structure of variability in upper extremity movement in individuals with chronic stroke. Methods Six participants with chronic stroke underwent CIMT for 4 hours/day for 2 weeks. Participants performed three trials of functional reach-to-grasp before and after CIMT. Temporal structure of variability was determined by calculating approximate entropy (ApEn) in shoulder, elbow and wrist flexion/extension joint angles. Results ApEn increased post CIMT, however, statistical significance was not achieved (p > 0.0167). Conclusion Future studies with larger sample size are warranted to investigate the effect of CIMT upon temporal structure of variability in UE movement. PMID:23084461

  18. Digital quadrature phase detection

    DOEpatents

    Smith, James A.; Johnson, John A.

    1992-01-01

    A system for detecting the phase of a frequency of phase modulated signal that includes digital quadrature sampling of the frequency or phase modulated signal at two times that are one quarter of a cycle of a reference signal apart, determination of the arctangent of the ratio of a first sampling of the frequency or phase modulated signal to the second sampling of the frequency or phase modulated signal, and a determination of quadrant in which the phase determination is increased by 2.pi. when the quadrant changes from the first quadrant to the fourth quadrant and decreased by 2.pi. when the quadrant changes from the fourth quadrant to the first quadrant whereby the absolute phase of the frequency or phase modulated signal can be determined using an arbitrary reference convention.

  19. Digital quadrature phase detection

    DOEpatents

    Smith, J.A.; Johnson, J.A.

    1992-05-26

    A system for detecting the phase of a frequency or phase modulated signal that includes digital quadrature sampling of the frequency or phase modulated signal at two times that are one quarter of a cycle of a reference signal apart, determination of the arctangent of the ratio of a first sampling of the frequency or phase modulated signal to the second sampling of the frequency or phase modulated signal, and a determination of quadrant in which the phase determination is increased by 2[pi] when the quadrant changes from the first quadrant to the fourth quadrant and decreased by 2[pi] when the quadrant changes from the fourth quadrant to the first quadrant whereby the absolute phase of the frequency or phase modulated signal can be determined using an arbitrary reference convention. 6 figs.

  20. Somatosensory temporal discrimination in essential tremor and isolated head and voice tremors.

    PubMed

    Conte, Antonella; Ferrazzano, Gina; Manzo, Nicoletta; Leodori, Giorgio; Fabbrini, Giovanni; Fasano, Alfonso; Tinazzi, Michele; Berardelli, Alfredo

    2015-05-01

    The aim of this study was to investigate the somatosensory temporal discrimination threshold in patients with essential tremor (sporadic and familial) and to evaluate whether somatosensory temporal discrimination threshold values differ depending on the body parts involved by tremor. We also investigated the somatosensory temporal discrimination in patients with isolated voice tremor. We enrolled 61 patients with tremor: 48 patients with essential tremor (31 patients with upper limb tremor alone, nine patients with head tremor alone, and eight patients with upper limb plus head tremor; 22 patients with familial vs. 26 sporadic essential tremor), 13 patients with isolated voice tremor, and 45 healthy subjects. Somatosensory temporal discrimination threshold values were normal in patients with familial essential tremor, whereas they were higher in patients with sporadic essential tremor. When we classified patients according to tremor distribution, somatosensory temporal discrimination threshold values were normal in patients with upper limb tremor and abnormal only in patients with isolated head tremor. Temporal discrimination threshold values were also abnormal in patients with isolated voice tremor. Somatosensory temporal discrimination processing is normal in patients with familial as well as in patients with sporadic essential tremor involving the upper limbs. By contrast, somatosensory temporal discrimination is altered in patients with isolated head tremor and voice tremor. This study with somatosensory temporal discrimination suggests that isolated head and voice tremors might possibly be considered as separate clinical entities from essential tremor. © 2015 International Parkinson and Movement Disorder Society.

  1. Barium appendicitis after upper gastrointestinal imaging.

    PubMed

    Novotny, Nathan M; Lillemoe, Keith D; Falimirski, Mark E

    2010-02-01

    Barium appendicitis (BA) is a rarely seen entity with fewer than 30 reports in the literature. However, it is a known complication of barium imaging. To report a case of BA in a patient whose computed tomography (CT) scan was initially read as foreign body ingestion. An 18-year-old man presented with right lower quadrant pain after upper gastrointestinal imaging 2 weeks prior. A CT scan was obtained of his abdomen and pelvis that revealed a finding that was interpreted as a foreign body at the area of the terminal ileum. A plain X-ray study of the abdomen revealed radiopaque appendicoliths. Pathology confirmed the diagnosis of barium appendicitis. BA is a rare entity and the pathogenesis is unclear. Shorter intervals between barium study and presentation with appendicitis usually correlate with fewer complications. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  2. Earth observations of the Andes Mountains taken during the STS-97 mission

    NASA Image and Video Library

    2000-12-10

    STS097-715-061 (10 December 2000) This view over the Central Andes Mountains in Argentina and Chile was taken on December 10, 2000 by one of the astronauts aboard the Earth-orbiting Space Shuttle Endeavour. Extending 5500 miles (8850 kilometers) along the western coast of South America from northern Colombia to Cape Horn in southern Chile, the Andes are the longest mountain range, above sea level, and the second highest range in the world. According to NASA scientists studying the STS-97 photo collection, this immense system came into existence nearly 70 million years ago. With numerous active volcanoes and a slow uplift, the building of the Andes Mountains continues today rising four inches (10 centimeters) per century, the scientists say. In this north-looking view, snow covers the higher peaks of the range, some of which rise to over 20000 feet (6100 meters) above sea level. Along the left or western portion of the view, clouds can be seen along coastal areas of Chile. In the bottom left quadrant of the scene, the blue waters of the Paloma Reservoir, a recreational lake, are visible. The folded Tontal Range (bottom center) and the Valle Fertil Range (upper right quadrant and partially cloud covered) of western Argentina can be seen. The rocks of these ranges, the scientists point out, are ancient compared to the younger volcanic peaks and ranges of the Andes. The city of San Juan, Argentina is visible on the eastern (right) base of the Tontal Range in the lower right quadrant of the view.

  3. Treatment of a supernumerary large breast with medial pedicle reduction mammaplasty.

    PubMed

    Cinpolat, Anı; Bektas, Gamze; Seyhan, Tamer; Ozad, Ulvan; Coskunfirat, O Koray

    2013-08-01

    Accessory breast tissues including nipples, areolas, and glandular tissue may develop on the chest in addition to two normal breasts. An accessory breast with a complete ductal system, areola, and nipple is termed a "supernumerary breast." Supernumerary nipples are fairly common, but complete supernumerary breasts are rare. This report describes an 18-year-old woman who presented with a complete supernumerary breast including a nipple-areola complex located on the upper outer quadrant of her left breast and causing severe breast asymmetry. She was referred to the authors for aesthetic reasons. Unilateral reduction mammaplasty was performed to remove the supernumerary breast and correct the breast asymmetry. The medial pedicle Wise technique was used for en bloc resection of the ectopic breast, including the nipple-areola complex together with the upper outer breast quadrant. The woman's postoperative course was uneventful. At 8 months after surgery, she was very satisfied with the results. Ectopic breast tissue can be treated by a variety of methods such as liposuction or excision. However, breast deformation because of a complete supernumerary breast is very rare, and research on the treatment of such patients is lacking. No reports describing surgical treatment for this condition were identified in the literature. The authors suggest that unilateral breast reduction is the most appropriate treatment, allowing excision of the accessory tissues, with the best possible cosmetic outcome. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

  4. Regional Differences in Tear Film Stability and Meibomian Glands in Patients With Aqueous-Deficient Dry Eye.

    PubMed

    Koh, Shizuka; Ikeda, Chikako; Fujimoto, Hisataka; Oie, Yoshinori; Soma, Takeshi; Maeda, Naoyuki; Nishida, Kohji

    2016-07-01

    To noninvasively investigate regional differences in tear film stability and meibomian glands in patients with aqueous-deficient dry eye. Forty-nine dry eyes and 31 normal eyes were analyzed. A corneal topographer with a tear film scanning function was used for noninvasive tear film break-up time (NI-TFBUT) measurements and meibomian gland observations. The NI-TFBUT values and location of the first tear film break-up point were recorded in four quadrants. Meibomian gland loss was graded for each eyelid using meiboscores. Lid margin abnormality was scored from zero to four according to the number of existing abnormalities. The NI-TFBUT values and meiboscores were compared between two groups, and regional differences in NI-TFBUT values and meiboscores were analyzed. Also, the correlation between the NI-TFBUT and ocular surface examination results were investigated. The NI-TFBUT values and meiboscores were significantly lower and higher, respectively, for the dry eye group than for the normal group. In the dry eye group, the occurrence rate for first tear film break-up was the highest in the inferior nasal quadrant, and the mean meiboscore was significantly higher for the upper eyelids than for the lower eyelids. The NI-TFBUT and lid margin abnormality scores showed a weak negative correlation, and the NI-TFBUT values and meiboscores showed no correlation. Compared to normal eyes, aqueous-deficient dry eyes show significant regional differences in tear film stability and meibomian glands. Considering these regional differences, the overall observation of the ocular surface, including both upper and lower eyelids, will aid clinicians in understanding this condition better.

  5. Hepatic Cyst Compressing The Right Atrial and Ventricular Inflow Tract: An Uncommon Cardiac Complication.

    PubMed

    Panchal, Maulik; Alansari, Ahmed; Wallack, Marc; Visco, Ferdinand; Williams, Susan; Sy, Alexander M

    2018-01-01

    Commonly reported complications of hepatic cysts are spontaneous hemorrhage, rupture into the peritoneal cavity, infection and compression of the biliary tree however cardiac complications are not commonly reported. We are presenting a case of a large liver cyst presenting with right atrial and ventricular inflow tract impingement resulting in cardiac symptoms. A 68 year-old Hispanic female presented with one month of fatigue and shortness of breath after household work and walking less than one block, right upper quadrant pain and weight loss. She had history of multiple hepatic cysts for more than 12 years, well-controlled diabetes and hypertension. Examination of the heart revealed tachycardia with regular heart sounds. There were no murmurs. She had tenderness in her right upper quadrant on palpation and an enlarged smooth liver. Rest of physical examination was unremarkable. CT scan of the abdomen showed multiple non-enhancing liver cysts in both lobes, with the largest measuring 12 x 15 x 17 cm which was significantly increased from her baseline of 7 x 8 x 10 cm in 2003. Echocardiogram showed normal left ventricular ejection fraction, grade 1 diastolic dysfunction and a hepatic cyst impinging RA and RV inflow tract. She had successful laparoscopic enucleation of liver cyst and subsequent relief from tachycardia, fatigue and shortness of breath. In conclusion, this case illustrates that hepatic cysts may become symptomatic after remaining quiescent for an extended period. They may present with unusual symptoms and clinicians should be mindful of rare complications, such as in this case.

  6. Corkscrew retinal vessels in neurofibromatosis type 1: report of 12 cases.

    PubMed

    Muci-Mendoza, R; Ramella, M; Fuenmayor-Rivera, D

    2002-03-01

    To describe a distinctive spectrum of retinal microvascular abnormalities in 12 patients with neurofibromatosis type 1 (NF-1). This is an observational prospective study of the ocular fundus evaluated by direct ophthalmoscopy with or without fluorescein angiography, to investigate retinal microvascular abnormalities in 32 patients with NF-1 and in 30 control subjects. The evaluation included a complete general and neurological physical examination and in some cases computed tomography, magnetic resonance imaging with gadolinium-DTPA, or both. The occurrence of a distinctive spectrum of retinal microvascular abnormalities is described in 12 patients with NF-1 (37.5%). At the lower end of the spectrum, present in 10 patients, the anomaly consisted of minuscule second or third order tortuous venules, which were called "corkscrew retinal vessels." These were usually isolated but in a few cases multiple. They flow towards the superior or inferior temporal veins. They had a length of one to two disc diameters. They ended either in a minute tuft or vanished on the retinal surface. The upper end of the spectrum was seen in only two patients. One of them had an exceptionally large venous anastomosis on the nasal retina and the other had an arteriovenous malformation extending over one retinal quadrant. None of the patients in the control group had such retinal microvascular abnormalities. The "corkscrew" retinal vessels described in this report constitute a broad spectrum of microvascular markers in NF-1 patients.

  7. Abnormal retinal nerve fiber layer thickness and macula lutea in patients with mild cognitive impairment and Alzheimer's disease.

    PubMed

    Gao, LiYan; Liu, Ying; Li, XiaoHong; Bai, QuanHao; Liu, Ping

    2015-01-01

    We investigated possible abnormalities in the retinal nerve fiber layer (RNFL) and macula lutea of patients diagnosed with Alzheimer's disease (AD) and mild cognitive impairment (MCI) and tested for any correlation with the severity of dementia. A total of 72 subjects, comprising 25 AD patients, 26 MCI patients and 21 healthy individuals (controls) were enrolled in this study. The thickness of the RNFL and volume of the macula lutea was determined using optical coherence tomography (OCT). When compared with controls, we found statistically significant thinning of the RNFL in AD patients at all clock-hour positions except 12:00, and nasal quadrant, 2:00, 3:00 and 4:00. After adjusting several risk factors, the average thickness of the RNFL was reduced in MCI patients compared to AD patients, with specific reductions at inferior quadrant, 5:00 and 6:00. Compared to controls, MCI patients showed a significant decrease in RNFL thickness only in the temporal quadrant, 8:00, 9:00 and 10:00. We found significant reduction in the volume of the macula lutea both in AD and MCI patients. Finally, we could not establish any correlation between patient Mini-Mental State Examination (MMSE) scores (an estimation of the severity of cognitive impairment) and any OCT parameter. Retinal degeneration in AD and MCI patients results in decreased thickness of the RNFL, and reduced macular volume in AD and MCI patients. However, there seems to be no correlation between these changes and the severity of dementia. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  8. Noninvasive imaging of human foveal capillary network using dual-conjugate adaptive optics.

    PubMed

    Popovic, Zoran; Knutsson, Per; Thaung, Jörgen; Owner-Petersen, Mette; Sjöstrand, Johan

    2011-04-22

    To demonstrate noninvasive imaging of human foveal capillary networks with a high-resolution, wide-field, dual-conjugate adaptive optics (DCAO) imaging instrument. The foveal capillary networks of five healthy subjects with no previous history of ocular or neurologic disease or surgery were imaged with a novel high-resolution, wide-field DCAO instrument. The foveal avascular zone (FAZ) in each image was defined using a manual procedure. An automated algorithm based on publicly available and custom-written software was used to identify vessels and extract morphologic FAZ and vessel parameters. Capillary densities were calculated in two annular regions of interest (ROIs) outside the FAZ (500 μm and 750 μm outer radius from the foveal center) and in the superior, inferior, temporal, and nasal quadrants within the two ROIs. Mean FAZ area was 0.302 ± 0.100 mm(2), and mean capillary density (length/area) in the inner ROI was 38.0 ± 4.0 mm(-1) and 36.4 ± 4.0 mm(-1) in the outer ROI. The difference in ROI capillary density was not significant. There was no significant difference in quadrant capillary density within the two ROIs or between quadrants irrespective of ROI. The authors have demonstrated a technique for noninvasive imaging and semiautomated detection and analysis of foveal capillaries. In comparison with other studies, their method yielded lower capillary densities than histology but similar results to the current clinical gold standard, fluorescein angiography. The increased field of view of the DCAO instrument opens up new possibilities for high-resolution noninvasive clinical imaging of foveal capillaries.

  9. Sector retinitis pigmentosa.

    PubMed

    Van Woerkom, Craig; Ferrucci, Steven

    2005-05-01

    Retinitis pigmentosa (RP) is one of the most common hereditary retinal dystrophies and causes of visual impairment affecting all age groups. The reported incidence varies, but is considered to be between 1 in 3,000 to 1 in 7,000. Sector retinitis pigmentosa is an atypical form of RP that is characterized by regionalized areas of bone spicule pigmentation, usually in the inferior quadrants of the retina. A 57-year-old Hispanic man with a history of previously diagnosed retinitis pigmentosa came to the clinic with a longstanding symptom of decreased vision at night. Bone spicule pigmentation was found in the nasal and inferior quadrants in each eye. He demonstrated superior and temporal visual-field loss corresponding to the areas of the affected retina. Clinical measurements of visual-field loss, best-corrected visual acuity, and ophthalmoscopic appearance have remained stable during the five years the patient has been followed. Sector retinitis pigmentosa is an atypical form of RP that is characterized by bilateral pigmentary retinopathy, usually isolated to the inferior quadrants. The remainder of the retina appears clinically normal, although studies have found functional abnormalities in these areas as well. Sector RP is generally considered a stationary to slowly progressive disease, with subnormal electro-retinogram findings and visual-field defects corresponding to the involved retinal sectors. Management of RP is very difficult because there are no proven methods of treatment. Studies have shown 15,000 IU of vitamin A palmitate per day may slow the progression, though this result is controversial. Low vision rehabilitation, long wavelength pass filters, and pedigree counseling remain the mainstay of management.

  10. Peripapillary nerve fiber layer thickness measurement reproducibility using optical coherence tomography.

    PubMed

    Villain, Max A; Greenfield, David S

    2003-01-01

    To assess reproducibility of quadrantic and clock hour sectors of retinal nerve fiber layer thickness in normal eyes using optical coherence tomography. Normal eyes of healthy volunteers meeting eligibility criteria were imaged by two inexperienced operators. Six 360 degrees circular scans with a diameter of 3.4 mm centered on the optic disc were obtained during each scanning session, and a baseline image was formed using 3 high-quality images defined by the software. Images were obtained on three different days within a 4-week period. Variance and coefficient of variation (CV) were calculated for quadrantic and retinal nerve fiber layer clock hour sectors obtained from the baseline image. Five normal eyes were scanned. Intraoperator reproducibility was high. The mean (+/- SD) CV for total retinal nerve fiber layer thickness was 5.3 +/- 3.82% and 4.33 +/- 3.7% for operators 1 and 2, respectively. Interoperator reproducibility was good with statistically similar variance for all quadrantic and clock hour retinal nerve fiber layer parameters (P = .42 to .99). The nasal retinal nerve fiber layer was the most variable sector for both operators (mean CV: 10.42% and 7.83% for operators 1 and 2, respectively). Differences in mean total, nasal, temporal, and superior retinal nerve fiber layer thickness were not statistically significant between operators for all eyes; however, for inferior retinal nerve fiber layer thickness, there was a significant (P = .0007) difference between operators in one eye. Peripapillary retinal nerve fiber layer thickness assessments using optical coherence tomography have good intraoperator and interoperator reproducibility. Inexperienced operators can generate useful measurement data with acceptable levels of variance.

  11. The effect of internal fixation lamp on anterior chamber angle width measured by anterior segment optical coherence tomography.

    PubMed

    Nakamine, Sakari; Sakai, Hiroshi; Arakaki, Yoshikuni; Yonahara, Michiko; Kaiya, Tadayoshi

    2018-01-01

    To study the effect of the internal fixation lamp on anterior chamber width measured by anterior segment optical coherence tomography. In a prospective cross sectional observational study, consecutive 22 right eyes of 22 patients (4 men and 18 women) with suspected primary angle closure underwent swept source domain anterior segment optical coherence tomography (AS-OCT), (CASIA SS-1000, Tomey, Nagoya, Japan). Anterior chamber parameters of angle opening distance (AOD), trabecular-iris angle (TIA), angle recess area (ARA) at 500 or 750 µm from scleral spur and pupil diameter were measured by AS-OCT in a three-dimensional mode in 4 quadrants (superior, inferior, temporal and nasal) in dark room setting both with and without internal fixation lamp. Anterior segment parameters of AOD 500 in superior, inferior and temporal quadrants, AOD 750 at superior and nasal, TIA 500 at superior, and inferior and TIA 750 at superior and nasal, and ARA 500 or 750 at superior and inferior with internal fixation lamp were greater and the pupil diameter was significantly (all P < 0.05, paired t test) smaller than when measured without fixation lamp. Internal fixation lamp of the anterior segment OCT makes the pupil constrict and angle wider. When using AS-OCT with usual setting with internal fixation lamp on with eyes in which the anterior chamber angle is narrow but open, it is recommended that the internal fixation lamp be turned off to ensure a clear indication as to whether the angle is open or closed in the dark.

  12. Optical coherence tomography detects characteristic retinal nerve fiber layer thickness corresponding to band atrophy of the optic discs.

    PubMed

    Kanamori, Akiyasu; Nakamura, Makoto; Matsui, Noriko; Nagai, Azusa; Nakanishi, Yoriko; Kusuhara, Sentaro; Yamada, Yuko; Negi, Akira

    2004-12-01

    To analyze retinal nerve fiber layer (RNFL) thickness in eyes with band atrophy by use of optical coherence tomography (OCT) and to evaluate the ability of OCT to detect this characteristic pattern of RNFL loss. Cross-sectional, retrospective study. Thirty-four eyes of 18 patients with bitemporal hemianopia caused by optic chiasm compression by chiasmal tumors were studied. All eyes were divided into 3 groups according to visual field loss grading after Goldmann perimetry. Retinal nerve fiber layer thickness measurements with OCT. Retinal nerve fiber layer thickness around the optic disc was measured by OCT (3.4-mm diameter circle). Calculation of the changes in OCT parameters, including the horizontal (nasal + temporal quadrant RNFL thickness) and vertical values (superior + inferior quadrant RNFL thickness) was based on data from 160 normal eyes. Comparison between the 3 visual field grading groups was done with the analysis of variance test. The receiver operating characteristic (ROC) curve for the horizontal and vertical value were calculated, and the areas under the curve (AUC) were compared. Retinal nerve fiber layer thickness in eyes with band atrophy decreased in all OCT parameters. The reduction rate in average and temporal RNFL thickness and horizontal value was correlated with visual field grading. The AUC of horizontal value was 0.970+/-0.011, which was significantly different from AUC of vertical value (0.903+/-0.022). The degree of RNFL thickness reduction correlated with that of visual field defects. Optical coherence tomography was able to identify the characteristic pattern of RNFL loss in these eyes.

  13. Decoding facial blends of emotion: visual field, attentional and hemispheric biases.

    PubMed

    Ross, Elliott D; Shayya, Luay; Champlain, Amanda; Monnot, Marilee; Prodan, Calin I

    2013-12-01

    Most clinical research assumes that modulation of facial expressions is lateralized predominantly across the right-left hemiface. However, social psychological research suggests that facial expressions are organized predominantly across the upper-lower face. Because humans learn to cognitively control facial expression for social purposes, the lower face may display a false emotion, typically a smile, to enable approach behavior. In contrast, the upper face may leak a person's true feeling state by producing a brief facial blend of emotion, i.e. a different emotion on the upper versus lower face. Previous studies from our laboratory have shown that upper facial emotions are processed preferentially by the right hemisphere under conditions of directed attention if facial blends of emotion are presented tachistoscopically to the mid left and right visual fields. This paper explores how facial blends are processed within the four visual quadrants. The results, combined with our previous research, demonstrate that lower more so than upper facial emotions are perceived best when presented to the viewer's left and right visual fields just above the horizontal axis. Upper facial emotions are perceived best when presented to the viewer's left visual field just above the horizontal axis under conditions of directed attention. Thus, by gazing at a person's left ear, which also avoids the social stigma of eye-to-eye contact, one's ability to decode facial expressions should be enhanced. Published by Elsevier Inc.

  14. Subcostal Transverse Abdominis Plane Block for Acute Pain Management: A Review.

    PubMed

    Soliz, Jose M; Lipski, Ian; Hancher-Hodges, Shannon; Speer, Barbra Bryce; Popat, Keyuri

    2017-10-01

    The subcostal transverse abdominis plane (SCTAP) block is the deposition of local anesthetic in the transverse abdominis plane inferior and parallel to the costal margin. There is a growing consensus that the SCTAP block provides better analgesia for upper abdominal incisions than the traditional transverse abdominis plane block. In addition, when used as part of a four-quadrant transverse abdominis plane block, the SCTAP block may provide adequate analgesia for major abdominal surgery. The purpose of this review is to discuss the SCTAP block, including its indications, technique, local anesthetic solutions, and outcomes.

  15. Infectious mononucleosis - not always a benign condition: a case report of infectious mononucleosis-associated acute acalculous cholecystitis.

    PubMed

    Cameron, Andrew; Akilan, Kosalan; Carr, David

    2018-03-01

    Infectious mononucleosis is typically a self-limited viral infection of adolescence and early adulthood that resolves in a period of weeks, causing no major sequelae. We describe a case of a healthy 18-year-old female diagnosed with infectious mononucleosis who also presented with right upper quadrant abdominal pain, moderate transaminitis, and cholestatic biochemistry. An ultrasound revealed acute acalculous cholecystitis, generally a condition seen in the context of critical illness. Further investigating emergency department patients with infectious mononucleosis is often not indicated, but may be important for those who present atypically.

  16. Splenic infarction at low altitude in a child with hemoglobin S-C disease.

    PubMed

    Alvarado, C S; Wyly, B; Buchanan, I; Fajman, W A

    1988-08-01

    We describe a 15-year-old black boy with hemoglobin S-C disease living in Atlanta (altitude 1,034 ft), with no prior history of aircraft or mountain travel, who developed splenic infarction. The clinical picture was characterized by severe left upper quadrant abdominal pain, fever, splenomegaly, and hematologic and scintigraphic evidence of functional asplenia. The diagnosis was suggested by liver/spleen scintigraphy and further confirmed by ultrasonography and computerized tomography (CT) of the spleen. Treatment consisted of analgesics, intravenous fluids, and short-term antibiotic therapy. The child recovered without sequelae.

  17. Thermography Examination of Abdominal Area Skin Temperatures in Individuals With and Without Focal-Onset Epilepsy.

    PubMed

    King, Hollis H; Cayce, Charles Thomas; Herrin, Jeph

    Early osteopathic theory and practice, and the work of the medical intuitive Edgar Cayce suggested that the abdominal areas of individuals with epilepsy would manifest "cold spots." The etiology for this phenomenon was thought to be abdominal adhesions caused by inflammation and viscero-somatic reflexes caused by adhesions or injury to visceral or musculoskeletal system structures. Indeed, until that advent of electroencephalography in the 1930s, medical practice regarding epilepsy focused on abdominal neural and visceral structures. Following two hypotheses were formulated to evaluate any abdominal temperature phenomena: (1) an abdominal quadrant division analysis would find one or more quadrants "colder" in the focal-onset epilepsy group (ICD9-CM 345.4 and 345.5) compared to controls. (2) Total abdominal areas of individuals with focal-onset epilepsy wound be colder than a control group. Overall, 50 patients with the diagnosis of focal-onset epilepsy were recruited from the office of the Epilepsy Foundation of Florida and 50 control subjects with no history of epilepsy were recruited through advertising to the public. Under controlled room conditions all subjects had infrared thermographic images made and recorded by Med-Hot Model MH-731 FLIR equipment. There were no significant demographic difference between experimental patients and control subjects, though the control group tended to be younger and more often male; however, these were controlled for in all analyses. In the quadrant analysis, there were significant differences in that more epileptic patients had colder left upper abdominal quadrant temperatures than the control group (66.8% versus 44.9%; P = .030). In the total abdominal analysis, however, there were no significant differences. The results support the hypothesis that individuals with focal-onset epilepsy have colder abdominal areas. If substantiated in further research, present study results will require further examination of the mechanisms of action for epilepsy, and suggest the need for re-examination of older formulations of abdominal epilepsy, including the place of abdominal injury, inflammation, and adhesions in epileptic pathology. The concept of somato-visceral and viscero-somatic neurological interactions is one of the possible mechanisms underlying the "cold spot" findings and warrants further consideration. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Optic properties of bile liquid crystals in human body

    PubMed Central

    Yang, Hai Ming; Wu, Jie; Li, Jin Yi; Zhou, Jian Li; He, Li Jun; Xu, Xian Fang

    2000-01-01

    AIM: To further study the properties of bile liquid crystals, and probe into the relationship between bile liquid crystals and gallbladder stone formation, and provide evidence for the prevention and treatment of cholecystolithiasis. METHODS: The optic properties of bile liquid crystals in human body were determined by the method of crystal optics under polarizing microscope with plane polarized light and perpendicular polarized light. RESULTS: Under a polarizing microscope with plane polarized light, bile liquid crystals scattered in bile appeared round, oval or irregularly round. The color of bile liquid crystals was a little lighter than that of the bile around. When the stage was turned round, the color of bile liquid crystals or the darkness and lightness of the color did not change obviously. On the border between bile liquid crystals and the bile around, brighter Becke-Line could be observed. When the microscope tube is lifted, Becke-Line moved inward, and when lowered, Becke-Line moved outward. Under a perpendicular polarized light, bile liquid crystals showd some special interference patterns, called Malta cross. When the stage was turning round at an angle of 360°, the Malta cross showed four times of extinction. In the vibrating direction of 45° angle of relative to upper and lower polarizing plate, gypsum test-board with optical path difference of 530 nm was inserted, the first and the third quadrants of Malt a cross appeared to be blue, and the second and the fourth quadrants appeared orange. When mica test-board with optical path difference of 147 nm was inserted, the first and the third quadrants of Malta cross appeared yellow, and the second and the fourth quadrants appeared dark grey. CONCLUSION: The bile liquid crystals were distributed in bile in the form of global grains. Their polychroism and absorption were slight, but the edge and Becke*Line were very clear. Its refractive index was larger than that of the bile. These liquid crystals were uniaxial positive crystals. The interference colors were the first order grey-white. The double refractive index of the liquid crystals was Δn = 0.011-0.015. PMID:11819567

  19. Pulp histology after Er:YAG laser cavity preparation in subhuman primates--a pilot study.

    PubMed

    Louw, N P; Pameijer, C H; Ackermann, W D; Ertl, T; Cappius, H J; Norval, G

    2002-08-01

    The aim of the study was to make a direct comparison of the pulpal effects of laser and turbine preparations in subhuman primates. One female baboon (Papio Ursinus ursinus), weighing 15 kg, was used. General anaesthesia was administered (ketamine 100 mg/ml/kg body weight) and maintained with acepromazine (10 mg/ml/kg body weight). Class V cavities were prepared buccally in a total of 28 teeth (7 in each quadrant). Teeth in the upper right and lower left quadrants were prepared using a conventional 330 carbide bur in a high-speed fibre-optic handpiece with copious water spray. Teeth in the upper left and lower right quadrants were prepared using an Er:YAG laser drill (Fotona Twinlight, Llubljana, Slovenia) delivering 500 mJ at a pulse rate of 10 Hz and a wavelength of 2940 nm. The animal was sacrificed after 25 days. After general anaesthesia as described before, perfusion fixation of the head was accomplished with 10% neutral buffered formalin, pumped through a catheter inserted into the left carotid artery. The jaws were removed and, using a 330 carbide bur in a high speed handpiece, a continuous groove was cut through the bone and the roots at the level of the middle third of all the roots to promote thorough fixation of pulpal tissue. Decalcification and grading of the severity of the pulpal responses were conducted according to standard procedures. Owing to procedural errors seven teeth, FDI numbers 23, 24, 31, 34, 35, 44 and 45, had to be eliminated. The turbine-prepared teeth (N = 11) had a mean remaining dentine thickness (RDT) of 0.77 mm (SD = 0.42) and the laser-prepared teeth (N = 10) had a mean RDT of 0.81 mm (SD = 0.60). All pulps appeared normal except in one turbine-prepared tooth (12 with RDT = 0.20) and one laser-prepared tooth (27 with RDT = 0.30, where irreversible damage was caused. The only other deviations from normal were seen in the laser-treated 41 (RDT = 0.69) and the turbine-treated 36 (RDT = 0.77) where moderate hyperaemia was seen. Within the limitations of this study it can be concluded that there is no significant difference between dental pulp of teeth where Class V cavities were prepared with an Er:YAG laser drill compared with those prepared with a standard turbine drill.

  20. Validation of an improved abnormality insertion method for medical image perception investigations

    NASA Astrophysics Data System (ADS)

    Madsen, Mark T.; Durst, Gregory R.; Caldwell, Robert T.; Schartz, Kevin M.; Thompson, Brad H.; Berbaum, Kevin S.

    2009-02-01

    The ability to insert abnormalities in clinical tomographic images makes image perception studies with medical images practical. We describe a new insertion technique and its experimental validation that uses complementary image masks to select an abnormality from a library and place it at a desired location. The method was validated using a 4-alternative forced-choice experiment. For each case, four quadrants were simultaneously displayed consisting of 5 consecutive frames of a chest CT with a pulmonary nodule. One quadrant was unaltered, while the other 3 had the nodule from the unaltered quadrant artificially inserted. 26 different sets were generated and repeated with order scrambling for a total of 52 cases. The cases were viewed by radiology staff and residents who ranked each quadrant by realistic appearance. On average, the observers were able to correctly identify the unaltered quadrant in 42% of cases, and identify the unaltered quadrant both times it appeared in 25% of cases. Consensus, defined by a majority of readers, correctly identified the unaltered quadrant in only 29% of 52 cases. For repeats, the consensus observer successfully identified the unaltered quadrant only once. We conclude that the insertion method can be used to reliably place abnormalities in perception experiments.

  1. Earth observations taken during STS-98 mission

    NASA Image and Video Library

    2001-02-07

    STS098-819-038 (17 February 2001) --- Much of Metropolitan Houston appears in this nearly vertical image photographed with a handheld 70mm camera onboard the Earth-orbiting Space Shuttle Atlantis. Interstate 45 and Highways 146 and 6 can be traced from lower right in Galveston County as they head into different directions toward a wide range of points in the city and its suburbs. NASA's Johnson Space Center can be easily pin-pointed just above the center point in the frame. Other points of interest in the area can be located by tracking over the various U.S., state and interstate highways---10, 51, 610 loop, Beltway 8 and others. Downtown Houston is at left center, but the so-called Uptown area is just out of frame at left. Galveston Bay takes up most of the upper right quadrant. Lake Houston is at upper left. A small piece of the Gulf of Mexico is in lower right.

  2. MSC

    NASA Image and Video Library

    1963-01-01

    S63-00950 (1963) --- An aerial view of Site 1, the Manned Spacecraft Center, in 1963 during early construction. The view faces the southwest. Highway 528 is at the top of the picture. Second Street runs basically north and south on the right side of the image, to the right or west and running parallel to that avenue is a drainage ditch. Winding through the site a Houston Lighting and Power Co. canal crosses over the drainage ditch near the top of the frame. Twin bridges over the canal are pictured at upper left which were constructed to allow traffic to enter and leave through MSC's secondary gateway. The unfinished red structure to the right of center and roughly 100 yards south of the elevated water storage tank is the Central Heating and Cooling Plant. In the upper left quadrant of the frame, construction appears very far along on the Central Data Office.

  3. ION ACCELERATOR

    DOEpatents

    Bell, J.S.

    1959-09-15

    An arrangement for the drift tubes in a linear accelerator is described whereby each drift tube acts to shield the particles from the influence of the accelerating field and focuses the particles passing through the tube. In one embodiment the drift tube is splii longitudinally into quadrants supported along the axis of the accelerator by webs from a yoke, the quadrants. webs, and yoke being of magnetic material. A magnetic focusing action is produced by energizing a winding on each web to set up a magnetic field between adjacent quadrants. In the other embodiment the quadrants are electrically insulated from each other and have opposite polarity voltages on adjacent quadrants to provide an electric focusing fleld for the particles, with the quadrants spaced sufficienily close enough to shield the particles within the tube from the accelerating electric field.

  4. Hemobilia: An Uncommon But Notable Cause of Upper Gastrointestinal Bleeding.

    PubMed

    Cathcart, Scott; Birk, John W; Tadros, Michael; Schuster, Micheal

    2017-10-01

    A literature review to improve practitioners' knowledge and performance concerning the epidemiology, diagnosis, and management of hemobilia. A search of Pubmed, Google Scholar, and Medline was conducted using the keyword hemobilia and relevant articles were reviewed and analyzed. The findings pertaining to hemobilia etiology, investigation, and management techniques were considered and organized by clinicians practiced in hemobilia. The majority of current hemobilia cases have an iatrogenic cause from either bile duct or liver manipulation. Blunt trauma is also a significant cause of hemobilia. The classic triad presentation of right upper quadrant pain, jaundice, and upper gastrointestinal bleeding is rarely seen. Computed tomography and magnetic resonance imaging are the preferred diagnostic modalities, and the preferred therapeutic management includes interventional radiology and endoscopic retrograde cholangiopancreatography. Surgery is rarely a therapeutic option. With advances in computed tomography and magnetic resonance imaging technology, diagnosis with these less invasive investigations are the favored option. However, traditional catheter angiography is still the gold standard. The management of significant hemobilia is still centered on arterial embolization, but arterial and biliary stents have become accepted alternative therapies.

  5. Higher operation temperature quadrant photon detectors of 2-11 μm wavelength radiation with large photosensitive areas

    NASA Astrophysics Data System (ADS)

    Pawluczyk, J.; Sosna, A.; Wojnowski, D.; Koźniewski, A.; Romanis, M.; Gawron, W.; Piotrowski, J.

    2017-10-01

    We report on the quadrant photon HgCdTe detectors optimized for 2-11 μm wavelength spectral range and Peltier or no cooling, and photosensitive area of a quad-cell of 1×1 to 4×4 mm. The devices are fabricated as photoconductors or multiple photovoltaic cells connected in series (PVM). The former are characterized by a relatively uniform photosensitive area. The PVM photovoltaic cells are distributed along the wafer surface, comprising a periodical stripe structure with a period of 20 μm. Within each period, there is an insensitive gap/trench < 9 μm wide between stripe mesas. The resulting spatial quantization error prevents positioning of the beam spot of size close to the period, but becomes negligible for the optimal spot size comparable to a quadrant-cell area. The photoconductors produce 1/f noise with about 10 kHz knee frequency, due to bias necessary for their operation. The PVM photodiodes are typically operated at 0 V bias, so they generate no 1/f noise and operation from DC is enabled. At 230 K, upper corner frequency of 16 to 100 MHz is obtained for photoconductor and 60 to 80 MHz for PVM, normalized detectivity D* 6×107 cm×Hz1/2/W to >1.4×108 cm×Hz1/2/W for photoconductor and >1.7×108 cm·Hz1/2/W for PVM, allowing for position control of the radiation beam with submicron accuracy at 16 MHz, 10.6 μm wavelength of pulsed radiation spot of 0.8 mm dia at the close-to-maximal input radiation power density in a range of detector linear operation.

  6. The quadrant method measuring four points is as a reliable and accurate as the quadrant method in the evaluation after anatomical double-bundle ACL reconstruction.

    PubMed

    Mochizuki, Yuta; Kaneko, Takao; Kawahara, Keisuke; Toyoda, Shinya; Kono, Norihiko; Hada, Masaru; Ikegami, Hiroyasu; Musha, Yoshiro

    2017-11-20

    The quadrant method was described by Bernard et al. and it has been widely used for postoperative evaluation of anterior cruciate ligament (ACL) reconstruction. The purpose of this research is to further develop the quadrant method measuring four points, which we named four-point quadrant method, and to compare with the quadrant method. Three-dimensional computed tomography (3D-CT) analyses were performed in 25 patients who underwent double-bundle ACL reconstruction using the outside-in technique. The four points in this study's quadrant method were defined as point1-highest, point2-deepest, point3-lowest, and point4-shallowest, in femoral tunnel position. Value of depth and height in each point was measured. Antero-medial (AM) tunnel is (depth1, height2) and postero-lateral (PL) tunnel is (depth3, height4) in this four-point quadrant method. The 3D-CT images were evaluated independently by 2 orthopaedic surgeons. A second measurement was performed by both observers after a 4-week interval. Intra- and inter-observer reliability was calculated by means of intra-class correlation coefficient (ICC). Also, the accuracy of the method was evaluated against the quadrant method. Intra-observer reliability was almost perfect for both AM and PL tunnel (ICC > 0.81). Inter-observer reliability of AM tunnel was substantial (ICC > 0.61) and that of PL tunnel was almost perfect (ICC > 0.81). The AM tunnel position was 0.13% deep, 0.58% high and PL tunnel position was 0.01% shallow, 0.13% low compared to quadrant method. The four-point quadrant method was found to have high intra- and inter-observer reliability and accuracy. This method can evaluate the tunnel position regardless of the shape and morphology of the bone tunnel aperture for use of comparison and can provide measurement that can be compared with various reconstruction methods. The four-point quadrant method of this study is considered to have clinical relevance in that it is a detailed and accurate tool for evaluating femoral tunnel position after ACL reconstruction. Case series, Level IV.

  7. Use of a photographic manipulation tool to assess corneal vascular response.

    PubMed

    Woods, Jill; Jones, Lyndon; Woods, Craig; Schneider, Simone; Fonn, Desmond

    2012-02-01

    Corneal vasculature change in contact lens wearers has been linked to the level of hypoxia within the cornea.To assess the impact a treatment has on limbal vessels, a sensitive method of measurement and quantification is required. A group of 21 highly myopic, hydrogel wearers, with preexisting signs of corneal hypoxia, were enrolled into a study where they wore sifilcon A penetrated hydrogel lenses (Dk/t ± 117), on a daily wear basis for 9 months. At all scheduled visits, photographs were taken of the superior, inferior, temporal, and nasal limbal regions which were then imported into Adobe Photoshop. A red-free filter was applied to enhance the contrast of the blood columns. In each quadrant, the length of the longest visible blood column was measured and the blood columns that penetrated 0.5 mm into the cornea were counted. A control group of 11 non-lens wearers was recruited. Their photographs were taken at the beginning of the study and 9 months later. An independent, masked observer assessed the photographs. There was a significant decrease in the maximum penetration of the blood column in all quadrants (p = 0.001) from baseline to the 9-month visit (e.g., superior: baseline 0.84 ± 0.39 mm; 9 months 0.63 ± 0.20 mm). There was also significant reduction in the number of visible blood columns longer than 0.5 mm in each quadrant (p = 0.001) from baseline to 9 months in all quadrants (e.g., superior: baseline 14.0 ± 8.2; 9 months 6.5 ± 6.0). The control group showed no change over time for the maximum blood column length (p = 0.638) or the number of columns 0.5 mm (p = 0.341). A group of highly myopic subjects exhibited reduction in the maximum length and number of blood columns in the cornea when ref it with a highly permeable silicone hydrogel material. The use of photography, along with Adobe Photoshop software, provides a reliable way of measuring corneal vascular responses over time.

  8. Elizabethkingia Meningoseptica in a Case of Biliary Tract Infection Following Liver Transplantation

    PubMed Central

    Musalem, Hebah M.; Honjol, Yazan N.; Tuleimat, Lin M.; Al Abbad, Saleh I.; Alsohaibani, Fahad I.

    2017-01-01

    Patient: Female, 55 Final Diagnosis: Percutaneous transhepatic cholangiography biliary drain infection with Elizabethkingia meningoseptica Symptoms: Right upper quadrant abdominal pain Medication: IV Ciprofloxacin 400 mg/12 hrs Clinical Procedure: None Specialty: Surgery and Internal Medicine Objective: Rare disease Background: Elizabethkingia meningoseptica (E. meningoseptica) is an aerobic Gram-negative bacillus known to thrive in moist environments, and is now recognized as a hospital-acquired infection, being found to contaminate hospital equipment, respiratory apparatus, hospital solutions, water, and drainage systems. Nosocomial infection with E. meningoseptica occurs in immunocompromised patients, requires specialized identification methods, and is resistant to conventional antibiotics. We report a case of E. meningoseptica infection arising from a percutaneous transhepatic biliary drainage (PTBD) tube. Case Report: A 55-year-old Saudi woman underwent liver transplantation. The post-operative period immediately following transplantation was complicated by anastomotic biliary stricture and bile leak, which was managed with percutaneous transhepatic cholangiography (PTC) with PTBD. She developed right upper quadrant abdominal pain, and her ultrasound (US) showed a sub-diaphragmatic collection. Microbial culture from the PTBD tube was positive for E. meningoseptica, which was treated with intravenous ciprofloxacin and metronidazole. This case is the second identified infection with E. meningoseptica at our specialist center, fifteen years after isolating the first case in a hemodialysis patient. We believe that this is the first case of E. meningoseptica infection to be reported in a liver transplant patient. Conclusions: The emerging nosocomial infectious organism, E. meningoseptica is being seen more often on hospital equipment and medical devices and in water. This case report highlights the need for awareness of this infection in hospitalized immunocompromised patients and the appropriate identification and management of infection with E. meningoseptica. PMID:28931801

  9. US of Right Upper Quadrant Pain in the Emergency Department: Diagnosing beyond Gallbladder and Biliary Disease.

    PubMed

    Joshi, Gayatri; Crawford, Kevin A; Hanna, Tarek N; Herr, Keith D; Dahiya, Nirvikar; Menias, Christine O

    2018-01-01

    Acute cholecystitis is the most common diagnosable cause for right upper quadrant abdominal (RUQ) pain in patients who present to the emergency department (ED). However, over one-third of patients initially thought to have acute cholecystitis actually have RUQ pain attributable to other causes. Ultrasonography (US) is the primary imaging modality of choice for initial imaging assessment and serves as a fast, cost-effective, and dynamic modality to provide a definitive diagnosis or a considerably narrowed list of differential possibilities. Multiple organ systems are included at standard RUQ US, and a variety of ultrasonographically diagnosable disease processes can be identified, including conditions of hepatic, pancreatic, adrenal, renal, gastrointestinal, vascular, and thoracic origin, all of which may result in RUQ pain. In certain cases, subsequent computed tomography, magnetic resonance (MR) imaging, MR cholangiopancreatography, or cholescintigraphy may be considered, depending on the clinical situation and US findings. Familiarity with the spectrum of disease processes outside of the gallbladder and biliary tree that may manifest with RUQ pain and recognition at US of these alternative conditions is pivotal for early diagnosis and appropriate management. Diagnosis at the time of initial US can reduce unnecessary imaging and its consequences, including excess cost, radiation exposure, nephrotoxic contrast medium use, and time to diagnosis, thereby translating into improved patient care and outcome. This article (a) reviews the causes of RUQ pain identifiable at US using an organ-system approach, (b) illustrates the US appearance of select conditions from each organ system with multimodality imaging correlates, and (c) discusses the relevant pathophysiology and treatment of these entities to aid in efficient direction of management. Online supplemental material is available for this article. © RSNA, 2018.

  10. Massive splenic infarction in Saudi patients with sickle cell anemia: a unique manifestation.

    PubMed

    Jama, Ali Hassan Al; Salem, Ahmed Hassan Al; Dabbous, Ibrahim Abdalla Al

    2002-03-01

    Splenic infarcts are common in patients with sickle cell anemia (SCA), but these are usually small and repetitive, leading ultimately to autosplenectomy. Massive splenic infarcts on the other hand are extremely rare. This is a report of our experience with 8 (4 males and 4 females) cases of massive splenic infarction in patients with SCA. Their ages ranged from 16 to 36 years (mean 22 years). Three presented with left upper quadrant abdominal pain and massive splenic infarction on admission, while the other 5 developed massive splenic infarction while in hospital. In 5 the precipitating factors were high altitude, postoperative, postpartum, salmonella septicemia, and strenuous exercise in one each, while the remaining 3 had severe generalized vasoocclusive crises. Although both ultrasound and CT scan of the abdomen were of diagnostic value, we found CT scan more accurate in delineating the size of infarction. All our patients were managed conservatively with I.V. fluids, analgesia, and blood transfusion when necessary. Diagnostic aspiration under ultrasound guidance was necessary in two patients to differentiate between massive splenic infarction and splenic abscess. Two patients required splenectomy during the same admission because of suspicion of secondary infection and abscess formation, while a third patient had splenectomy 2 months after the attack because of persistent left upper quadrant abdominal pain. In all the 3 histology of the spleen showed congestive splenomegaly with massive infarction. All of our patients survived. Two patients subsequently developed autosplenectomy while the remaining 3 continue to have persistent but asymptomatic splenomegaly. Massive splenic infarction is a rare and unique complication of SCA in the Eastern Province of Saudi Arabia, and for early diagnosis and treatment, physicians caring for these patients should be aware of such a complication.

  11. Gallstones and common bile duct calculi in infancy and childhood.

    PubMed

    Kumar, R; Nguyen, K; Shun, A

    2000-03-01

    Gallstones and common bile duct calculi have been increasingly diagnosed in recent years in infants and children. The present study aims to review the spectrum of this disorder in the last two decades. During the period 1979-96 a total of 102 consecutive infants and children were diagnosed in Royal Alexandra Hospital for Children with gallstones or common bile duct calculi. A detailed retrospective analysis and follow-up of these children form the basis of the present report. The median age at presentation was 10 years. Recurrent right upper quadrant pain was the most common clinical presentation. The male-to-female ratio was 3:2 and this male predominance was noted in all the age groups. Aetiologically three identifiable groupings were noted: idiopathic disease (n = 66), haematological diseases (n = 23) and specific non-haematological disease (n = 13). The incidence of idiopathic and haematological stones had increased two-fold in the second half of the study. The majority of children (86%) underwent surgical correction. Choledocholithiasis (CDL) was noted in 18 children (18%). Jaundice was commonly associated with abdominal pain in this group. A higher incidence of common bile duct calculi was noted in females and children less than 5 years of age (P < 0.01). Common bile duct calculi were accurately diagnosed by pre-operative imaging in all 18 children. Surgical correction was required in all except two. The present study suggests an increasing incidence of gallstones in children. Cholelithiasis in children occurs commonly in boys, is idiopathic in aetiology and presents with a vague right upper quadrant pain. Choledocholithiasis is not uncommon in children, occurs more commonly in girls aged < 5 years and presents with jaundice or abnormal liver function tests.

  12. Tele-ultrasound and paramedics: real-time remote physician guidance of the Focused Assessment With Sonography for Trauma examination.

    PubMed

    Boniface, Keith S; Shokoohi, Hamid; Smith, E Reed; Scantlebury, Kari

    2011-06-01

    The aim of this study was to examine the capability of ultrasound-naïve paramedics to obtain interpretable Focused Assessment With Sonography for Trauma (FAST) images under the remote direction of emergency physicians (EPs). Paramedics without experience using ultrasound participated in a 20-minute lecture covering orientation to the ultrasound machine and the FAST examination. The paramedics subsequently performed FAST examinations on a model patient, whereas the EP remained in another room, out of visual contact. The EP communicated with the paramedic via radio, viewing video from the ultrasound machine on a monitor and directing the probe movements to obtain the views of the FAST examination. We examined the success rate, time to complete the examinations, and adequacy of images from the paramedics' first FAST examination. Fifty-one paramedics performed their first FAST examinations and were able to successfully complete 100% of the views of the FAST. The median time from probe placement to examination completion was 262 seconds (interquartile range, 206-343 seconds). The median time to complete right upper quadrant (RUQ) versus left upper quadrant (LUQ) views was 39 and 50 seconds, respectively. The time to complete the LUQ scan took significantly longer than the RUQ (P < .01). Paramedics completed cardiac and pelvic view in a median time of 42 and 25 seconds, respectively. The study demonstrated that paramedics with no prior ultrasound experience could obtain FAST images under remote guidance from experienced EPs in less than 5 minutes. Given rapidly evolving data transmission technology, this has applicability in battlefield, remote, and rural prehospital settings. Copyright © 2011 Elsevier Inc. All rights reserved.

  13. Hybrid laparoscopic-robotic management of type IVa choledochal cyst in the setting of prior Roux-en-Y gastric bypass: video case report and review of the literature.

    PubMed

    Chang, Julietta; Walsh, R Matthew; El-Hayek, Kevin

    2015-06-01

    Choledochal cysts are rare congenital disease of the biliary system. The recommended treatment of these lesions is surgical excision with biliary enteric reconstruction. In patients with normal anatomy, Roux-en-Y hepaticojejunostomy is preferred. However, different options in biliary reconstruction must be entertained in those with abnormal anatomy. Our patient is a 39-year-old female, who during workup for bariatric surgery two years prior to presentation, was found to have a 6 cm dilation of her common bile duct. She underwent a laparoscopic Roux-en-Y gastric bypass (LRYGB) in 2011 at an outside facility, with no planned intervention on her biliary tree. Ultimately, she developed right upper quadrant pain two years following her RYGB. Upon further workup including right upper quadrant ultrasound, an extrahepatic choledochal cyst was confirmed and she was referred to our institution for definitive care. The patient was taken to the operating room for resection of the choledochal cyst with hepatoenteric reconstruction. The dissection and resection of the cyst commenced laparoscopically. After performing a generous Kocher maneuver, we demonstrated that there was adequate mobilization of the duodenum to perform a tension free hepaticoduodenostomy, which was performed robotically. Her postoperative course was uneventful, and she was discharged home on postoperative day 3. At one month follow up, the patient was doing well with symptom resolution. Her final pathology revealed a choledochal cyst which was negative for dysplasia or carcinoma. Long-term follow up has been recommended with yearly alkaline phosphatase levels. Here we present a video of the technical considerations during a robot-assisted laparoscopic biliary reconstruction in a patient with a prior Roux-en-Y gastric bypass with a type IVA choledochal cyst.

  14. Patients with mild cognitive impairment have an abnormal upper-alpha event-related desynchronization/synchronization (ERD/ERS) during a task of temporal attention.

    PubMed

    Caravaglios, Giuseppe; Muscoso, Emma Gabriella; Di Maria, Giulia; Costanzo, Erminio

    2015-03-01

    There are several evidences indicating that an impairment in attention-executive functions is present in prodromal Alzheimer's disease and predict future global cognitive decline. In particular, the issue of temporal orienting of attention in patients with mild cognitive impairment (MCI) due to Alzheimer's disease has been overlooked. The present research aimed to explore whether subtle deficits of cortical activation are present in these patients early in the course of the disease. We studied the upper-alpha event-related synchronization/desynchronization phenomenon during a paradigm of temporal orientation of attention. MCI patients (n = 27) and healthy elderly controls (n = 15) performed a task in which periodically omitted tones had to be predicted and their virtual onset time had to be marked by pressing a button. Single-trial responses were measured, respectively, before and after the motor response. Then, upper-alpha responses were compared to upper-alpha power during eyes-closed resting state. The time course of the task was characterized by two different behavioral conditions: (1) a pre-event epoch, in which the subject awaited the virtual onset of the omitted tone, (2) a post-event epoch (after button pressing), in which the subject was in a post-motor response condition. The principal findings are: (1) during the waiting epoch, only healthy elderly had an upper-alpha ERD at the level of both temporal and posterior brain regions; (2) during the post-motor epoch, the aMCI patients had a weaker upper-alpha ERS on prefrontal regions; (3) only healthy elderly showed a laterality effect: (a) during the waiting epoch, the upper-alpha ERD was greater at the level of the right posterior-temporal lead; during the post-motor epoch, the upper alpha ERS was greater on the left prefrontal lead. The relevance of these findings is that the weaker upper-alpha response observed in aMCI patients is evident even if the accuracy of the behavioral performance (i.e., button pressing) is still spared. This abnormal upper-alpha response might represent an early biomarker of the attention-executive network impairment in MCI due to Alzheimer's disease.

  15. Detection of primary angle closure using anterior segment optical coherence tomography in Asian eyes.

    PubMed

    Nolan, Winifred P; See, Jovina L; Chew, Paul T K; Friedman, David S; Smith, Scott D; Radhakrishnan, Sunita; Zheng, Ce; Foster, Paul J; Aung, Tin

    2007-01-01

    To evaluate noncontact anterior segment optical coherence technology (AS-OCT) as a qualitative method of imaging the anterior chamber angle and to determine its ability to detect primary angle closure when compared with gonioscopy in Asian subjects. Prospective observational case series. Two hundred three subjects were recruited from glaucoma clinics in Singapore with diagnoses of primary angle closure, primary open-angle glaucoma, ocular hypertension, or cataract. Both eyes (if eligible) of each patient were included in the study. Exclusion criteria were pseudophakia or previous glaucoma surgery. Images of the nasal, temporal, and inferior angles were obtained with AS-OCT in dark and then light conditions. Gonioscopic angle width was graded using the Spaeth classification for each quadrant in low lighting conditions. Angle closure was defined by AS-OCT as contact between the peripheral iris and angle wall anterior to the scleral spur and by gonioscopy as a Spaeth grade of 0 degree (posterior trabecular meshwork not visible). Comparison of the 2 methods in detecting angle closure was done by eye and by individual. Sensitivities and specificities of AS-OCT were calculated using gonioscopy as the reference standard. Complete data were available for 342 eyes of 200 patients. Of the patients, 70.9% had a clinical diagnosis of treated or untreated primary angle closure. Angle closure in > or =1 quadrants was detected by AS-OCT in 142 (71%) patients (228 [66.7%] eyes) and by gonioscopy in 99 (49.5%) patients (152 [44.4%] eyes). The inferior angle was closed more frequently than the nasal or temporal quadrants using both AS-OCT and gonioscopy. When performed under dark conditions, AS-OCT identified 98% of those subjects found to have angle closure on gonioscopy (95% confidence interval [CI], 92.2-99.6) and led to the characterization of 44.6% of those found to have open angles on gonioscopy to have angle closure as well. With gonioscopy as the reference standard, specificity of AS-OCT in the dark was 55.4% (95% CI, 45.2-65.2) for detecting individuals with angle closure. Anterior segment OCT is a rapid noncontact method of imaging angle structures. It is highly sensitive in detecting angle closure when compared with gonioscopy. More persons are found to have closed angles with AS-OCT than with gonioscopy.

  16. Quadrant anode image sensor

    NASA Technical Reports Server (NTRS)

    Lampton, M.; Malina, R. F.

    1976-01-01

    A position-sensitive event-counting electronic readout system for microchannel plates (MCPs) is described that offers the advantages of high spatial resolution and fast time resolution. The technique relies upon a four-quadrant electron-collecting anode located behind the output face of the microchannel plate, so that the electron cloud from each detected event is partly intercepted by each of the four quadrants. The relative amounts of charge collected by each quadrant depend on event position, permitting each event to be localized with two ratio circuits. A prototype quadrant anode system for ion, electron, and extreme ultraviolet imaging is described. The spatial resolution achieved, about 10 microns, allows individual MCP channels to be distinguished.

  17. Scanning Laser Polarimetry and Optical Coherence Tomography for Detection of Retinal Nerve Fiber Layer Defects

    PubMed Central

    Oh, Jong-Hyun

    2009-01-01

    Purpose To compare the ability of scanning laser polarimetry with variable corneal compensation (GDx-VCC) and Stratus optical coherence tomography (OCT) to detect photographic retinal nerve fiber layer (RNFL) defects. Methods This retrospective cross-sectional study included 45 eyes of 45 consecutive glaucoma patients with RNFL defects in red-free fundus photographs. The superior and inferior temporal quadrants in each eye were included for data analysis separately. The location and presence of RNFL defects seen in red-free fundus photographs were compared with those seen in GDx-VCC deviation maps and OCT RNFL analysis maps for each quadrant. Results Of the 90 quadrants (45 eyes), 31 (34%) had no apparent RNFL defects, 29 (32%) had focal RNFL defects, and 30 (33%) had diffuse RNFL defects in red-free fundus photographs. The highest agreement between GDx-VCC and red-free photography was 73% when we defined GDx-VCC RNFL defects as a cluster of three or more color-coded squares (p<5%) along the traveling line of the retinal nerve fiber in the GDx-VCC deviation map (kappa value, 0.388; 95% confidence interval (CI), 0.195 to 0.582). The highest agreement between OCT and red-free photography was 85% (kappa value, 0.666; 95% CI, 0.506 to 0.825) when a value of 5% outside the normal limit for the OCT analysis map was used as a cut-off value for OCT RNFL defects. Conclusions According to the kappa values, the agreement between GDx-VCC deviation maps and red-free photography was poor, whereas the agreement between OCT analysis maps and red-free photography was good. PMID:19794943

  18. Retinal vessel oxygen saturation in a healthy young Chinese population.

    PubMed

    Yang, Wei; Fu, Yue; Dong, Yanmin; Lin, Leilei; Huang, Xia; Li, Yujie; Lin, Xiaofeng; Gao, Qianying

    2016-06-01

    To measure retinal vessel oxygen saturation in a healthy young Chinese population and to determine the effects of multiple factors (gender, age, dioptre, vessel diameter and ocular perfusion pressure - OPP) on retinal oxygen saturation. A total of 126 healthy Chinese individuals aged from 19 to 30 were included in this study. A retinal oximeter (Oxymap T1) was used to measure retinal vessel oxygen saturation by retinal imaging at two different wavelengths. The mean retinal vessel oxygen saturation (Sat_O2 ) of arterioles, venules and arteriovenous (AV) difference overall and in four separate quadrants were measured. Intra-ocular pressure, blood pressure, finger pulse oximetry value, vessel diameter and dioptre were also measured. The correlations between OPP and dioptre, OPP and vessel diameter, and dioptre and vessel diameter were analysed. And the effects of multiple factors on the retinal oxygen saturation were analysed. The mean oxygen saturation was 93.2 ± 6.3% in the retinal arterioles, 60.4 ± 5.3% in venules and 32.9 ± 6.4% in AV difference. The temporal quadrants had lower measurements of arteriolar and venular oxygen saturation and AV difference compared with nasal quadrants (p < 0.001). The oxygen saturation of the arterioles, venules and AV difference were unaffected by any unique factor. Arteriolar and venular retinal oxygen saturation correlated negatively with the product of dioptre and OPP. Arteriolar retinal oxygen saturation correlated positively with the product of dioptre and vessel diameter. This study provided a normal reference of Sat_O2 in healthy young Chinese individuals. It was a reflection of the normal state of retinal oxygen metabolism affected by several factors. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  19. Visual Assessment on Coastal Cruise Tourism: A Preliminary Planning Using Importance Performance Analysis

    NASA Astrophysics Data System (ADS)

    Trisutomo, S.

    2017-07-01

    Importance-Performance Analysis (IPA) has been widely applied in many cases. In this research, IPA was applied to measure perceive on coastal tourism objects and its possibility to be developed as coastal cruise tourism in Makassar. Three objects, i.e. Akkarena recreational site, Losari public space at waterfront, and Paotere traditional Phinisi ships port, were selected and assessed visually from water area by a group of purposive resource persons. The importance and performance of 10 attributes of each site were scored using Likert scale from 1 to 5. Data were processed by SPSS-21 than resulted Cartesian graph which the scores were divided in four quadrants: Quadrant I concentric here, Quadrant II keep up the good work, Quadrant III low priority, and Quadrant IV possible overkill. The attributes in each quadrant could be considered as the platform for preliminary planning of coastal cruise tour in Makassar

  20. Research on detecting spot selection and signal pretreatment of four-quadrant detector

    NASA Astrophysics Data System (ADS)

    Liu, Wenli; Han, Shaokun

    2018-01-01

    The four-quadrant detector is a photoelectric position sensor based on the photovoltaic effect. It is widely used in many fields such as target azimuth measurement, end-guided weapon and so on. The selection of the spot and the calculation of the center position are one of the main factors that affect the accuracy of the position measurement of the fourquadrant detector. In order to improve the positioning accuracy of the four-quadrant detector, the method of determining the best spot size is obtained from the theoretical research. The output signal of the four-quadrant detector is a weak narrow pulse signal, which needs to be magnified and widened at high magnitudes. The signal preprocessing method is simulated and experimentally studied. Detecting the spot and the signal processing is realized by the four-quadrant detector, which is important for the use of quadrant detectors for high-precision position measurements.

  1. Photoreceptors in a primitive mammal, the South American opossum, Didelphis marsupialis aurita: characterization with anti-opsin immunolabeling.

    PubMed

    Ahnelt, P K; Hokoç, J N; Röhlich, P

    1995-01-01

    The retinas of placental mammals appear to lack the large number and morphological diversity of cone subtypes found in diurnal reptiles. We have now studied the photoreceptor layer of a South American marsupial (Didelphis marsupialis aurita) by peanut agglutinin labeling of the cone sheath and by labeling of cone outer segments with monoclonal anti-visual pigment antibodies that have been proven to consistently label middle-to-long wavelength (COS-1) and short-wavelength (OS-2) cone subpopulations in placental mammals. Besides a dominant rod population (max. = 400,000/mm2) four subtypes of cones (max. = 3000/mm2) were identified. The outer segments of three cone subtypes were labeled by COS-1: a double cone with a principal cone containing a colorless oil droplet, a single cone with oil droplet, and another single cone. A second group of single cones lacking oil droplets was labeled by OS-2 antibody. The topography of these cone subtypes showed striking anisotropies. The COS-1 labeled single cones without oil droplets were found all over the retina and constituted the dominant population in the area centralis located in the temporal quadrant of the upper, tapetal hemisphere. The population of OS-2 labeled cones was also ubiquitous although slightly higher in the upper hemisphere (200/mm2). The COS-1 labeled cones bearing an oil droplet, including the principal member of double cones, were concentrated (800/mm2) in the inferior, non-tapetal half of the retina. The two spectral types of single cones resemble those of dichromatic photopic systems in most placental mammals. The additional set of COS-1 labeled cones is a distinct marsupial feature. The presence of oil droplets in this cone subpopulation, its absence in the area centralis, and the correlation with the non-tapetal inferior hemisphere suggest a functional specialization, possibly for mesopic conditions. Thus, sauropsid features have been retained but probably with a modified function.

  2. Evaluation of posterior ocular changes using enhanced depth imaging-optical coherence tomography in patients with obstructive sleep apnea syndrome.

    PubMed

    Yuvacı, İsa; Pangal, Emine; Bayram, Nurettin; Yüksel, Sevgi Arık; Alabay, Bedirhan; Ağadayı, Alperen; Sırakaya, Ender; Gülhan, Ahmet

    2016-01-01

    Evaluation of the nerve fiber thicknesses of the macula, choroid, and retina using the apnea-hypopnea index in individuals with obstructive sleep apnea syndrome (OSAS) without systemic components. Prospective, controlled study. The central macular, choroidal, and retinal nerve fiber layer (RNFL) thicknesses were evaluated using enhanced depth imaging-spectral domain optical coherence tomography in individuals with OSAS. In people with severe OSAS who had received treatment, posterior ocular structures were examined over 3 months (4th and 12th weeks), and changes were evaluated. Only the right eyes of the participants were evaluated in the study. A total of 72 people were involved in the study, with 18 in the control group and 19 with mild, 16 with moderate, and 19 with severe OSAS. No significant difference was found among the groups in terms of demographic measures. No significant differences were found among the groups in terms of the measures of central macular, central subfoveal choroidal (CSCT), temporal choroidal, nasal choroidal, and RNFL thicknesses. In severe OSAS cases in which treatment was administered, although subjective clinical recovery was observed, statistically significant thinning was detected during the 3-month follow-up period in the CSCT, general RNFL, as well as in the inferior and superior nasal quadrants, and temporal superior quadrant (p=0.005, p=0.009, p=0.039, p=0.003, and p=0.02, respectively). In the group with severe OSAS, thinning in some posterior ocular tissues was observed. Although patients with severe OSAS may experience clinical recovery, we recommend that they would be followed up in terms of ocular ischemic injury.

  3. Comprehensive Three-Dimensional Analysis of the Neuroretinal Rim in Glaucoma Using High-Density Spectral-Domain Optical Coherence Tomography Volume Scans

    PubMed Central

    Tsikata, Edem; Lee, Ramon; Shieh, Eric; Simavli, Huseyin; Que, Christian J.; Guo, Rong; Khoueir, Ziad; de Boer, Johannes; Chen, Teresa C.

    2016-01-01

    Purpose To describe spectral-domain optical coherence tomography (OCT) methods for quantifying neuroretinal rim tissue in glaucoma and to compare these methods to the traditional retinal nerve fiber layer thickness diagnostic parameter. Methods Neuroretinal rim parameters derived from three-dimensional (3D) volume scans were compared with the two-dimensional (2D) Spectralis retinal nerve fiber layer (RNFL) thickness scans for diagnostic capability. This study analyzed one eye per patient of 104 glaucoma patients and 58 healthy subjects. The shortest distances between the cup surface and the OCT-based disc margin were automatically calculated to determine the thickness and area of the minimum distance band (MDB) neuroretinal rim parameter. Traditional 150-μm reference surface–based rim parameters (volume, area, and thickness) were also calculated. The diagnostic capabilities of these five parameters were compared with RNFL thickness using the area under the receiver operating characteristic (AUROC) curves. Results The MDB thickness had significantly higher diagnostic capability than the RNFL thickness in the nasal (0.913 vs. 0.818, P = 0.004) and temporal (0.922 vs. 0.858, P = 0.026) quadrants and the inferonasal (0.950 vs. 0.897, P = 0.011) and superonasal (0.933 vs. 0.868, P = 0.012) sectors. The MDB area and the three neuroretinal rim parameters based on the 150-μm reference surface had diagnostic capabilities similar to RNFL thickness. Conclusions The 3D MDB thickness had a high diagnostic capability for glaucoma and may be of significant clinical utility. It had higher diagnostic capability than the RNFL thickness in the nasal and temporal quadrants and the inferonasal and superonasal sectors. PMID:27768203

  4. Association Between Retinal Nerve Fiber Layer Thickness and Abnormalities of Vision in People With Human Immunodeficiency Virus Infection

    PubMed Central

    Kalyani, Partho S.; Holland, Gary N.; Fawzi, Amani A.; Arantes, Tiago E.F.; Yu, Fei; Sadun, Alfredo A.

    2014-01-01

    Purpose To investigate relationships between contrast sensitivity (CS), color vision, and retinal nerve fiber layer (RNFL) among people with human immunodeficiency virus (HIV) infection; to evaluate the effect of time since diagnosis of HIV infection on RNFL thickness. Design Noninterventional cross-sectional study. Methods We evaluated 102 eyes of 57 HIV-infected individuals without ocular opportunistic infections. Peripapillary RNFL thickness was determined with spectraldomain optical coherence tomography in 4 quadrants. CS was measured with the Pelli-Robson technique (expressed as logCS); color vision was measured with the Lanthony desaturated 15-hue technique (expressed as color confusion index [C-index], with higher scores indicating worse color vision). Correlations between values were assessed using Spearman correlation coefficients. Results Median RNFL thickness (average of 4 quadrants) was 102.9 μm (range, 75.0–134.7 μm). Median logCS was 1.90 (range, 1.25–1.95). Median C-index was 1.58 (range, 0.96–4.07). Temporal RNFL thickness was correlated with logCS (r = 0.295, P = .003) and C-index (r = −0.338, P = .0005). Time since diagnosis of HIV infection was shorter for those with thick average RNFL than for those with thin average RNFL (P = .18). Conclusions Both worse CS and worse color vision are correlated with thinning of the temporal RNFL, with possible threshold effects. Increased prevalences of abnormal CS and abnormal color vision in this population are therefore likely attributable to neuroretinal compromise. This pattern of structural and functional losses may reflect preferential damage to small-caliber axons in the maculopapillary bundle, possibly associated with mitochondrial dysfunction, providing a potential disease mechanism for HIV-associated “neuroretinal disorder.” PMID:22245459

  5. The influence of corneal astigmatism on retinal nerve fiber layer thickness and optic nerve head parameter measurements by spectral-domain optical coherence tomography.

    PubMed

    Liu, Lin; Zou, Jun; Huang, Hui; Yang, Jian-guo; Chen, Shao-rong

    2012-05-23

    To evaluate the influence of corneal astigmatism (CA) on retinal nerve fiber layer (RNFL) thickness and optic nerve head(ONH) parameters measured with spectral-domain optical coherence tomography (OCT) in high myopes patients before refractive surgery. Seventy eyes of 35 consecutive refractive surgery candidates were included in this study. The mean age of the subjects was 26.42 ± 6.95 years, the average CA was -1.17 diopters (D; SD 0.64; range -0.2 to-3.3D), All subjects in this study were WTR CA. 34 eyes were in the normal CA group with a mean CA was -0.67 ± 0.28D, 36 eyes were in the high CA group with an average CA of -1.65 ± 0.49D. All subjects underwent ophthalmic examination and imaging with the Cirrus HD OCT. No significant difference was noted in the average cup-to-disk ratio, vertical cup-to-disk ratio and cup volume (all P values > 0.05). Compared with the normal CA group, the high CA group had a larger disc area and rim area, thinner RNFL thickness in the temporal quadrant, and the superotemporal and inferotemporal peaks were farther to the temporal horizon (All P values < 0.05). There were no significant differences between the two groups in global average RNFL thickness, as well as superior, nasal and inferior quadrant RNFL thickness (all P values > 0.05). The degree of with-the-rule CA should be considered when interpreting ONH parameters and peripapillary RNFL thickness measured by the Cirrus HD OCT. The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1148475676881895.

  6. Sclerosant extravasation as a complication of sclerosing endotherapy for bleeding gastric varices.

    PubMed

    Cheng, H-C; Cheng, P-N; Tsai, Y-M; Tsai, H-M; Chen, C-Y

    2004-03-01

    We report here the case of a 65-year-old woman who suffered intraperitoneal sclerosant leakage after endoscopic injection sclerotherapy for bleeding gastric varices. In total, 3 ml of N-butyl-2-cyanoacrylate and Lipiodol mixture was injected. The patient developed mild fever and pain over the left upper quadrant and flank after the procedure. In addition to a Lipiodol-filled gastric varix, the imaging studies disclosed a wide spread of Lipiodol over the left peritoneal cavity. The patient was kept fasting with parenteral antibiotics and nutrition. She responded well to the treatment, and all of the symptoms had subsided 6 days later.

  7. Noise of deflectors used for flow attachment with STOL-OTW configurations

    NASA Technical Reports Server (NTRS)

    Vonglahn, U. H.; Groesbeck, D.

    1977-01-01

    Future STOL aircraft may utilize engine-over-the-wing installations in which the exhaust nozzles are located above and separated from the upper surface of the wing. An external jet flow deflector can be used with such installations to provide flow attachment to the wing/flap surfaces for lift augmentation. Deflector noise in the flyover plane measured with several model-scale nozzle/deflector/wing configurations is examined. The deflector-associated noise is correlated in terms of velocity and geometry parameters. The data also indicate that the effective overall sound pressure level of the deflector-associated noise peaks in the forward quadrant near 40 deg from the inlet axis.

  8. The splenic syndrome in individuals with sickle cell trait.

    PubMed

    Goodman, Jessica; Hassell, Kathryn; Irwin, David; Witkowski, Ewa H; Nuss, Rachelle

    2014-12-01

    The medical records of 25 individuals with sickle cell trait and altitude-associated splenic infarct, reported to two Colorado physicians, were reviewed. Electrospray mass spectroscopy was performed on blood samples from a cohort of 10 of the individuals to rapidly confirm beta hemoglobin phenotype. Only males were identified with a 1.4:1 ratio of non-African Americans to African Americans, and 44% of African Americans and 85% of non-African Americans were unaware they had sickle cell trait. Left upper quadrant pain and an elevated bilirubin were nearly uniformly present. Either abdominal CT or ultrasound was confirmatory. Conservative treatment at a lower altitude generally resulted in a favorable outcome.

  9. Hematoma of the falciform ligament: a rare cause of acute abdomen.

    PubMed

    Sari, Serkan; Ersöz, Feyzullah; Güneş, Mehmet Emin; Paşaoğlu, Esra; Arikan, Soykan

    2011-01-01

    Hematoma or abscess of the liver ligaments is extremely rare, and hematoma of the falciform ligament has been sporadically reported. We report the case of a 70-year-old female who presented with a three-day history of right upper quadrant abdominal pain, fever and nausea. With a preoperative diagnosis of probable perforated acalculous cholecystitis, the patient underwent emergency surgery. Hematoma of the falciform ligament was found. Wide excision of the falciform ligament including the hematoma with abscess was performed. Although pathology of the falciform ligament is rare, it should be included in the differential diagnosis of acute abdomen, especially in the case of antiaggregant drug usage.

  10. Corkscrew retinal vessels in neurofibromatosis type 1: report of 12 cases

    PubMed Central

    Muci-Mendoza, R; Ramella, M; Fuenmayor-Rivera, D

    2002-01-01

    Aim: To describe a distinctive spectrum of retinal microvascular abnormalities in 12 patients with neurofibromatosis type 1 (NF-1). Methods: This is an observational prospective study of the ocular fundus evaluated by direct ophthalmoscopy with or without fluorescein angiography, to investigate retinal microvascular abnormalities in 32 patients with NF-1 and in 30 control subjects. The evaluation included a complete general and neurological physical examination and in some cases computed tomography, magnetic resonance imaging with gadolinium-DTPA, or both. Results: The occurrence of a distinctive spectrum of retinal microvascular abnormalities is described in 12 patients with NF-1 (37.5%). At the lower end of the spectrum, present in 10 patients, the anomaly consisted of minuscule second or third order tortuous venules, which were called “corkscrew retinal vessels.” These were usually isolated but in a few cases multiple. They flow towards the superior or inferior temporal veins. They had a length of one to two disc diameters. They ended either in a minute tuft or vanished on the retinal surface. The upper end of the spectrum was seen in only two patients. One of them had an exceptionally large venous anastomosis on the nasal retina and the other had an arteriovenous malformation extending over one retinal quadrant. None of the patients in the control group had such retinal microvascular abnormalities. Conclusion: The “corkscrew” retinal vessels described in this report constitute a broad spectrum of microvascular markers in NF-1 patients. PMID:11864883

  11. Temporal Variability of Upper-level Winds at the Eastern Range, Western Range and Wallops Flight Facility

    NASA Technical Reports Server (NTRS)

    Decker, Ryan K.; Barbre, Robert E., Jr.

    2014-01-01

    Space launch vehicles incorporate upper-level wind profiles to determine wind effects on the vehicle and for a commit to launch decision. These assessments incorporate wind profiles measured hours prior to launch and may not represent the actual wind the vehicle will fly through. Uncertainty in the upper-level winds over the time period between the assessment and launch can be mitigated by a statistical analysis of wind change over time periods of interest using historical data from the launch range. Five sets of temporal wind pairs at various times (.75, 1.5, 2, 3 and 4-hrs) at the Eastern Range, Western Range and Wallops Flight Facility were developed for use in upper-level wind assessments. Database development procedures as well as statistical analysis of temporal wind variability at each launch range will be presented.

  12. Underwater Docking of Autonomous Undersea Vehicles Using Optical Terminal Guidance

    DTIC Science & Technology

    1997-10-01

    simply using a brighter beacon. Scattered light within the field-of-view is imaged almost equally into each of the four quadrants of a photodetector...received by adjacent quadrants a great deal of the forward scattered light can be rejected when the signals from the four quadrants are subsequently...employed to aim the nose of the vehicle at the light source because the illumination is equal in all four quadrants only when the tracker’s optical axis is

  13. Florid cemento osseous dysplasia in association with dentigerous cyst.

    PubMed

    Sanjai, Karpagaselvi; Kumarswamy, Jayalakshmi; Kumar, Vinod K; Patil, Archana

    2010-07-01

    We present a case of florid cemento-osseous dysplasia occurring in a 20-year-old Indian woman. The subject presented with three lesions involving the maxillary right quadrant, maxillary left quadrant and mandibular left quadrant. The mandibular left quadrant also demonstrated a cyst.The diagnosis was made by correlating the clinical presentation with that of the radiological and histopathological findings. This is a rare entity because of an unusual combination of Asian race along with the association of dentigerous cyst.

  14. "Perhaps Irrelevant". The Iconography of Tycho Brahe's Small Gilt Brass Quadrant.

    PubMed

    Perkins, Emma L; Taub, Liba

    2015-01-01

    When Tycho Brahe published a description of his astronomical instruments in 1598 as part of a strategy to procure royal patronage, it was not with one of his grander, precision measurement tools that he opened his account, but rather a small brass quadrant with limited observational utility. The defining feature of this instrument was seemingly a small emblematic image inscribed within the arc of the quadrant. Through this symbolic motif Tycho conveyed a moralising message about the relative worth of astronomy. Considering a range of visual productions that may have influenced his iconography, the present paper situates the quadrant within the broader context of Renaissance visual culture and examines the significance of the quadrant in Tycho's wider instrument collection.

  15. Analysis of the spatial and temporal variability of mountain snowpack and terrestrial water storage in the Upper Snake River, USA

    EPA Science Inventory

    The spatial and temporal relationships of winter snowpack and terrestrial water storage (TWS) in the Upper Snake River were analyzed for water years 2001–2010 at a monthly time step. We coupled a regionally validated snow model with gravimetric measurements of the Earth’s water...

  16. Behavioral research in pigeons with ARENA: An automated remote environmental navigation apparatus

    PubMed Central

    Leising, Kenneth J.; Garlick, Dennis; Parenteau, Michael; Blaisdell, Aaron P.

    2009-01-01

    Three experiments established the effectiveness of an Automated Remote Environmental Navigation Apparatus (ARENA) developed in our lab to study behavioral processes in pigeons. The technology utilizes one or more wireless modules, each capable of presenting colored lights as visual stimuli to signal reward and of detecting subject peck responses. In Experiment 1, subjects were instrumentally shaped to peck at a single ARENA module following an unsuccessful autoshaping procedure. In Experiment 2, pigeons were trained with a simultaneous discrimination procedure during which two modules were illuminated different colors; pecks to one color (S+) were reinforced while pecks to the other color (S−) were not. Pigeons learned to preferentially peck the module displaying the S+. In Experiment 3, two modules were lit the same color concurrently from a set of six colors in a conditional discrimination task. For three of the colors pecks to the module in one location (e.g., upper quadrant) were reinforced while for the remaining colors pecks at the other module (e.g., lower quadrant) were reinforced. After learning this discrimination, the color-reinforced location assignments were reversed. Pigeons successfully acquired the reversal. ARENA is an automated system for open-field studies and a more ecologically valid alternative to the touchscreen. PMID:19429204

  17. Gangrenous Appendicitis in a Boy with Mobile Caecum.

    PubMed

    Keskin, Suat; Keskin, Zeynep; Gunduz, Metin; Sekmenli, Taner; Kivrak, Hatice Yazar

    2015-04-01

    A mobile caecum and ascending colon is an uncommon congenital disorder, and it is even rarer as the cause of an acute abdomen during childhood. This report presents the case of a 6-year-old boy with acute gangrenous appendicitis with a mobile caecum and ascending colon. Data from the surgical course, as well as laboratory and imaging studies, were acquired and carefully examined. Emergency ultrasound (US) was performed and revealed no signs of appendicitis in the right lower quadrant. Serial imaging study, including non-enhanced computed tomography (CT), was performed. An imaging study identified epigastric appendicitis with mobile caecum. Surgery was executed under general anesthesia with a median incision extending from the epigastrium to the suprapubic region. The caecum was mobile and placed in the right epigastric area, next to the left lobe of the liver and gallbladder. The gangrenous appendix was discovered posterior to the caecum and transverse colon, enlarging to the left upper quadrant. Appendectomy was executed, the gangrenous appendix was confirmed pathologically, and the patient was released 4 days later. In the US, if there are unusual clinical findings or no findings in patients with abdominal pain, CT is beneficial in determining the location of the caecum and appendix and preventing misdiagnosis in children.

  18. Diapycnal Advection by Double Diffusion and Turbulence in the Ocean

    DTIC Science & Technology

    1999-09-01

    quadrant of the map. To evaluate the significance of the finger-regime results, we have implemented a simple statistical test. The dissipation ratio...accepted in nearly all of quadrants I, III and IV of the finger-favorable regime. However, the data in quadrant II (Rp ɚ,Ri> 1) strongly supports the...region of parameter space ( quadrant II, (Rp ɚ,Ri> 1)). 44 1.01 R R R P p p 1.1 1.5 2.5 5 10 30 1001.01 1.1 1.5 2.5 5 10 30

  19. Study of Retinal Nerve Fibre Layer Thickness and Visual Contrast Sensitivity in HIV Positive Individuals.

    PubMed

    Paul, Rudrajit; Ghosh, Asim K; Nag, Adwaita; Biswas, Shyamapada; Naiya, Britisundar; Mondal, Jayati

    2017-06-01

    Measurement of Retinal Nerve Fibre Layer Thickness (RNFLT) by Optical Coherence Tomography (OCT) is a sensitive, non invasive and cheap method of detecting early retinal changes in a variety of diseases. In HIV infection, RNFLT is altered and this may have effect on other visual functions like Contrast Sensitivity (CS) and visual acuity. Such ocular pathology can affect the daily life and profession (especially driving) of HIV infected individuals. However, studies on this topic in HIV infected population are rare from India. To study RNFLT, CS and their correlation in a sample of HIV positive Indian population. The present cross-sectional study was done in a tertiary care medical college hospital of Eastern India between May 2016 and September 2016. We did this study on HIV positive subjects with no clinically apparent ocular infection or other pathology. In this study, we have measured the RNFLT using the HRA-OCT Spectralis machine. The CS was tested using a smartphone version of the Pellie-Robson chart. CD4 count, visual acuity and colour vision were also tested. The data was analysed using SPSS version 20.0 for any correlation between these parameters. Pearson coefficient was used for continuous data and Spearman rank correlation was used for categorical data. A p-value <0.05 was considered significant. We had 17 patients, that is 34 eyes. RNFLT loss was found in 21% of the eyes and borderline thinning was found in a further 26%. Predominantly, the temporal quadrant was involved. The mean of log CS was 1.33±0.38. Taking 1.5 as the cut-off value for normalcy, 47% of the eyes tested showed decreased CS. Log CS showed significant correlation with RNFLT of the temporal quadrant only (r=0.37; 95% C.I. 0.041 to 0.631; p=0.02). Temporal RNFLT also showed statistical correlation with the CD4 count. The low CS was also significantly correlated with low visual acuity (r=0.5). In HIV infected persons, subtle ocular changes may occur and this may affect visual functions quite early. Hence, a comprehensive eye check-up should include parameters like CS and OCT.

  20. Effect of improper scan alignment on retinal nerve fiber layer thickness measurements using Stratus optical coherence tomograph.

    PubMed

    Vizzeri, Gianmarco; Bowd, Christopher; Medeiros, Felipe A; Weinreb, Robert N; Zangwill, Linda M

    2008-08-01

    Misalignment of the Stratus optical coherence tomograph scan circle placed by the operator around the optic nerve head (ONH) during each retinal nerve fiber layer (RNFL) examination can affect the instrument reproducibility and its theoretical ability to detect true structural changes in the RNFL thickness over time. We evaluated the effect of scan circle placement on RNFL measurements. Observational clinical study. Sixteen eyes of 8 normal participants were examined using the Stratus optical coherence tomograph Fast RNFL thickness acquisition protocol (software version 4.0.7; Carl Zeiss Meditec, Dublin, CA). Four consecutive images were taken by the same operator with the circular scan centered on the optic nerve head. Four images each with the scan displaced superiorly, inferiorly, temporally, and nasally were also acquired. Differences in average and sectoral RNFL thicknesses were determined. For the centered scans, the coefficients of variation (CV) and the intraclass correlation coefficient for the average RNFL thickness measured were calculated. When the average RNFL thickness of the centered scans was compared with the average RNFL thickness of the displaced scans individually using analysis of variance with post-hoc analysis, no difference was found between the average RNFL thickness of the nasally (105.2 microm), superiorly (106.2 microm), or inferiorly (104.1 microm) displaced scans and the centered scans (106.4 microm). However, a significant difference (analysis of variance with Dunnett's test: F=8.82, P<0.0001) was found between temporally displaced scans (115.8 microm) and centered scans. Significant differences in sectoral RNFL thickness measurements were found between centered and each displaced scan. The coefficient of variation for average RNFL thickness was 1.75% and intraclass correlation coefficient was 0.95. In normal eyes, average RNFL thickness measurements are robust and similar with significant superior, inferior, and nasal scan displacement, but average RNFL thickness is greater when scans are displaced temporally. Parapapillary scan misalignment produces significant changes in RNFL assessment characterized by an increase in measured RNFL thickness in the quadrant in which the scan is closer to the disc, and a significant decrease in RNFL thickness in the quadrant in which the scan is displaced further from the optic disc.

  1. Interactions of stars and interstellar matter in Scorpio Centaurus

    NASA Technical Reports Server (NTRS)

    De Geus, E. J.

    1992-01-01

    The interaction of the stars in the Scorpio-Centaurus OB association with the ambient interstellar medium is investigated. Large H I loops in the fourth galactic quadrant are parts of expanding shells surrounding the subgroups of the association. The energy output of the original stellar population of the subgroups is calculated. Comparison with the kinetic energy of the shells shows that the energy output of the stars in the subgroups is sufficient to form the shells. The masses of the shells are consistent with those of giant molecular clouds GMCs, suggesting that the shells consist of swept-up, original GMC material. The influence of the expanding shell around the young Upper-Scorpius subgroup on the morphology of the Ophiuchus molecular clouds is investigated. The interaction of the shell with the Ophiuchus clouds accounts for the presence of a slow shock and for the shape of the elongated dark clouds connected to the Rho Oph dense cloud. The close passage of the trajectory of the runaway star Zeta Oph by the center of the Upper-Scorpius shell, combined with the time scale of formation of the shell, strongly suggests that the star has originated in the Upper-Scorpius subgroup.

  2. Diversity of tree vegetation on different slopes in Sangkulirang – Mangkalihat exokarst area

    NASA Astrophysics Data System (ADS)

    Suwasono, R. A.; Matius, P.; Sutedjo

    2018-04-01

    The Karst ecosystem in East Kalimantan is predominantly located in the Sangkulirang-Mangkalihat covering an area of 1,867,676 hectares. The exokarst are all features that may be found on a surface karst landscape. The objective of this study was to determine the diversity of tree vegetation (diameters >10 cm) on different slopes. Six study locations were selected as replications where each location consisted of the different of slopes. The sample plot was set up 15 plots in each location on quadrants of 10 m x 10 m. 538 individuals had been found in the study sites consisting of 163 species, 100 genera and 43 family. The Dipterocarpaceae was dominant on slopes and the upper ridges, while Shorea sp. has dominated on the upper ridges. The highest diversity index (H’) of 4.04were found on the slopes and valley while the Species Richness Index (R) and Evenness Index (e) were high in all three slopes. The highest Similarity Index (ISs) of41.06was in the slopes and valley, while the highest Decimilarity Index (ID) of 67.30were in the slopes and upper ridges. Meanwhile, the overall diversity of species in the Sangkulirang-Mangkalihat exokarst area is high.

  3. Elastic band causing exfoliation of the upper permanent central incisors.

    PubMed

    Alves, Monica Ghislaine Oliveira; Kitakawa, Dárcio; Becker, Joao Batista Macedo; Brandão, Adriana Aigotti Haberbeck; Cabral, Luiz Antonio Guimarães; Almeida, Janete Dias

    2015-01-01

    Objective. This study reports a case in which elastic band use culminated in the loss of the incisors. Case Report. An 11-year-old white girl was seen complaining of pain, with purulent discharge and severe tooth mobility. The bone destruction detected radiographically in the region, despite its single location and absence in posterior quadrants of the maxilla and/or mandible, was similar to that observed in Langerhans cell disease. To our surprise, an elastic band involving the midportion of the roots of the two upper central incisors was found during biopsy. The debris was removed and a metal wire was placed in permanent maxillary right and left incisors. The patient was followed up, but no improvement in tooth mobility was observed. Bone loss increased, and internal resorption and root exposure occurred, which culminated in the extraction of permanent maxillary right and left incisors. Conclusion. The present case highlights the fact that professionals sometimes are confronted by anamnestic reports never seen before.

  4. Epidermoid cyst of the spleen

    PubMed Central

    Vo, Quoc Duy; Monnard, Etienne; Hoogewoud, Henri Marcel

    2013-01-01

    We report the case of a patient with a palpable mass and abdominal pain in the left upper quadrant. A physical examination revealed tenderness in this region. An ultrasound performed initially showed a large cystic structure. A CT examination revealed a large cyst originating in the spleen with loculations in its upper part and focal calcification in the wall. On MRI, the cystic mass showed high signal on T1-weighted and T2-weighted images. The carbohydrate antigen 19-9 (CA 19-9) was measured at 88 U/ml (standard <37.1 mUI/l). According to the imaging examinations and laboratory tests performed, it was impossible to determine if the splenic cyst was parasitic or non-parasitic. Given the most important risks of complications encountered in parasitic cysts, it was decided to treat this splenic cyst as a parasitic cyst. For this reason, an elective laparoscopic splenectomy with preoperative embolisation of the splenic artery was performed. The histological diagnosis was a primary epidermoid splenic cyst with inner lining epithelial cells. PMID:23667225

  5. Site-specific adaptive remodeling of Greyhound metacarpal cortical bone subjected to asymmetrical cyclic loading.

    PubMed

    Johnson, K A; Skinner, G A; Muir, P

    2001-05-01

    To quantify geometric, inertial, and histomorphometric properties at the mid-diaphyseal level of left and right metacarpal bones (MCB) of racing Greyhounds. MCB from 7 racing Greyhounds euthanatized for reasons unrelated to MCB abnormalities. Mid-diaphyseal transverse sections of left and right MCB were stained with H&E or microradiographed. Images of stained sections were digitized, and cross-sectional area, cortical area, and maximum and minimum area moments of inertia of each bone were determined. Histomorphometric data (osteonal density, osteonal birefringence, and endosteal new lamellar bone thickness) were collected in 4 quadrants (dorsal, palmar, lateral, medial). Values were compared between limbs and among bones and quadrants. Cross-sectional area, cortical area, and maximum and minimum moments of inertia of left MCB-IV and -V were significantly greater, compared with contralateral bones. Overall osteonal densities in the dorsal quadrants of left MCB were greater, compared with lateral and medial quadrants. Also, percentage of birefringent osteons was significantly greater in the dorsal quadrant of left MCB-III, -IV, and -V, compared with the palmar quadrant. Thickness of new endosteal lamellar bone was not significantly influenced by limb, bone, or quadrant. Increased cortical thickness and geometric properties of left MCB-IV and -V of Greyhounds, together with altered turnover and orientation of osteons in the dorsal quadrants of left MCB, are site-specific adaptive responses associated with asymmetric cyclic loading as a result of racing on circular tracks. Site-specific adaptive remodeling may be important in the etiopathogenesis of fatigue fractures in racing Greyhounds.

  6. Specific Location of Disc Hemorrhage is Linked to Nerve Fiber Layer Defects.

    PubMed

    Yoo, Young Cheol; Kim, Joon Mo; Park, Han Seok; Yoo, Chungkwon; Shim, Seong Hee; Won, Yu Sam; Park, Ki Ho; Chang, Robert T

    2017-06-01

    To investigate the relationship between retinal nerve fiber layer (RNFL) defects and the quadrant and proximal location of disc hemorrhages (DHs) in a large population examined for health screening. A total of 168,044 subjects older than 20 years underwent a single screening ophthalmic examination with color fundus photography as part of a comprehensive health screening program. The presence and location of DHs and RNFL defects were assessed. The DH locations were defined according to the quadrant location (inferotemporal, superotemporal, inferonasal, or superonasal) and the most proximal end of DHs relative to the disc center (cup base, cup margin, disc rim, or extrapapillary region). Using these two location descriptors as independent variables, a logistic regression analysis was conducted to explore the effects of DH location on RNFL defects. Two hundred twenty-six eyes had DH and 120 (53.1%) of them had RNFL defects. After adjusting for proximal location, DHs located in the inferotemporal quadrant accompanied RFNL defects 12 times more frequently than those in the superonasal quadrant (odds ratio [OR], 11.81; P = .004). Conversely, after adjusting for quadrant location, the ORs for an associated RNFL defect were 3.73 (P < .001), 16.54 (P < .001), and 8.91 (P = .002) for DHs with the proximal end at the disc rim, cup margin, and cup base, respectively. Among the four quadrants and four proximal locations, DHs were identified most frequently in the inferotemporal quadrant and outside the disc, respectively. Some DH locations, such as the inferotemporal quadrant and the cup margin, were associated with RNFL defects, whereas others were not.

  7. Localization of MEG human brain responses to retinotopic visual stimuli with contrasting source reconstruction approaches

    PubMed Central

    Cicmil, Nela; Bridge, Holly; Parker, Andrew J.; Woolrich, Mark W.; Krug, Kristine

    2014-01-01

    Magnetoencephalography (MEG) allows the physiological recording of human brain activity at high temporal resolution. However, spatial localization of the source of the MEG signal is an ill-posed problem as the signal alone cannot constrain a unique solution and additional prior assumptions must be enforced. An adequate source reconstruction method for investigating the human visual system should place the sources of early visual activity in known locations in the occipital cortex. We localized sources of retinotopic MEG signals from the human brain with contrasting reconstruction approaches (minimum norm, multiple sparse priors, and beamformer) and compared these to the visual retinotopic map obtained with fMRI in the same individuals. When reconstructing brain responses to visual stimuli that differed by angular position, we found reliable localization to the appropriate retinotopic visual field quadrant by a minimum norm approach and by beamforming. Retinotopic map eccentricity in accordance with the fMRI map could not consistently be localized using an annular stimulus with any reconstruction method, but confining eccentricity stimuli to one visual field quadrant resulted in significant improvement with the minimum norm. These results inform the application of source analysis approaches for future MEG studies of the visual system, and indicate some current limits on localization accuracy of MEG signals. PMID:24904268

  8. An Integral Approach to Counseling Ethics

    ERIC Educational Resources Information Center

    Foster, Durwin; Black, Timothy G.

    2007-01-01

    The authors offer an integral approach to counseling ethics using K. Wilber's (2000a, 2000b) integral metatheory. The article examines traditional counseling ethics through the lens of K. Wilber's (2000a, 2000b) "all-quadrants, all-levels" model, consisting of quadrants, levels, lines, states, and types. The authors begin with the 4 quadrants and…

  9. Quadrant Analysis as a Strategic Planning Technique in Curriculum Development and Program Marketing.

    ERIC Educational Resources Information Center

    Lynch, James; And Others

    1996-01-01

    Quadrant analysis, a widely-used research technique, is suggested as useful in college or university strategic planning. The technique uses consumer preference data and produces information suitable for a wide variety of curriculum and marketing decisions. Basic quadrant analysis design is described, and advanced variations are discussed, with…

  10. Strong diabetes

    PubMed Central

    Young, James; Anwar, Aresh

    2007-01-01

    The case of a 36‐year‐old male professional bodybuilder is reported. He presented to the accident and emergency department with right upper quadrant pain. This was on the background of a 15‐year history of anabolic steroid and growth hormone misuse. Examination revealed mild hepatomegaly and a random blood sugar of 30.2 mmol/l. There was no evidence of ketonuria or acidosis. Biochemical evidence of hepatitis was found, and the patient was in acute renal failure. He was given a sliding scale of insulin and an intravenous infusion of crystalloid. The hepatitis and hyperglycaemia settled with conservative treatment. It is believed that this is the first reported case of frank diabetes precipitated by supraphysiological recreational growth hormone misuse. PMID:17324962

  11. HTV-4 undocking

    NASA Image and Video Library

    2013-09-04

    ISS036-E-039525 (04 Sept. 2013) --- One of the Expedition 36 crew members aboard the International Space Station took this picture showing part of the Japanese HTV-4 unmanned cargo spacecraft, backdropped against countries in northern Africa, following its unberthing from the orbital outpost. HTV-4, after backing away from the flying complex, headed for re-entry into Earth's atmosphere, burning upon re-entry. The Strait of Gibraltar, where the Atlantic Ocean and the Mediterranean Sea meet, is in the upper left quadrant of the photo. HTV-4 was launched by Japan?s Aerospace Exploration Agency (JAXA) on Aug. 4 of this year in order to bring up supplies for the astronauts and cosmonauts onboard the station.

  12. Fires in Kamchatka Peninsula, Russia

    NASA Technical Reports Server (NTRS)

    2002-01-01

    Numerous thermal anomalies were detected on the Kamchatka Peninsula in northeastern Russia in late June and early July by the Moderate Resolution Imaging Spectroradiometer (MODIS). Some of the anomalies (red dots) were fires, but at least one was the result of ongoing volcanic activity at one of the Peninsula's numerous active volcanoes. The erupting volcano, called Sheveluch, can be seen most clearly in the image from July 8, 2002. It is located in the upper right quadrant of the image, and appears as a grayish circular patch amid the surrounding green vegetation. In its center is a red dot indicating that MODIS detected a thermal signature coming from the restless volcano. Credit: Jacques Descloitres, MODIS Land Rapid Response Team, NASA/GSFC

  13. Space Shuttle Endeavour flies by Johnson Space Center

    NASA Image and Video Library

    2008-12-11

    JSC2008-E-154359 (11 Dec. 2008) --- The Space Shuttle Endeavour flies over the Clear Lake area and the Johnson Space Center after having spent the night at a stopover in Tarrant County, while mounted on a modified Boeing 747 shuttle carrier aircraft. Endeavour landed in California on Nov. 30 and was en route back to Florida. This photo, taken from the rear station of a NASA T-38 aircraft, shows the main part of the 1625-acre JSC site. The extremely clear weather allows viewing all the way to Houston's central business district. Harris County Domed Stadium and the Houston NFL franchise's stadium are visible in the upper left quadrant of the photo.

  14. Hepatic veno-occlusive disease during chemotherapy for nephroblastoma: successful and safe treatment with defibrotide. Report of a clinical case.

    PubMed

    Cecinati, Valerio; Giordano, Paola; De Leonardis, Francesco; Grassi, Massimo; Arcamone, Giampaolo; De Mattia, Domenico; Santoro, Nicola

    2009-01-01

    Here we report a case of administration of defibrotide in an 11 months old infant with hepatic veno-occlusive disease during chemotherapy for nephroblastoma. He presented with abdominal distension, a weight gain of 15%, ascites, hepatomegaly with right upper quadrant pain, thrombocytopenia and hypertransaminasemia. Despite therapy, his clinical conditions aggravated, and, therefore intravenous administration of defibrotide on a compassionate-use basis was started. The dosage was 15 mg/kg/day in 4 divided doses, which was increased gradually (in 3 days) to 40 mg/kg/day in 4 divided doses. Defibrotide proved safe and effective in resolving clinical symptoms and normalizing serological findings in the syndrome.

  15. Haemorrhagic cholecystitis in a newly anticoagulated patient.

    PubMed

    Kinnear, Ned; Hennessey, Derek Barry; Thomas, Rebecca

    2017-04-12

    A 74-year-old man undergoing rehabilitation after pneumonia developed right upper quadrant abdominal pain. Five days earlier he had been commenced on apixaban for a new diagnosis of atrial fibrillation. Ultrasound and CT scans revealed an acalculous grossly thickened gallbladder, with high attenuation non-echogenic material both within and surrounding the structure. Active contrast extravasation was seen at the neck. On laparotomy, a perforated internally bleeding gallbladder containing a single calculus was found, with significant free blood within the abdomen. After cholecystectomy, the patient recovered slowly in hospital before nursing home placement. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  16. 62. VIEW OF MILL SOLUTION TANKS FLOOR FROM WEST. THE ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    62. VIEW OF MILL SOLUTION TANKS FLOOR FROM WEST. THE BOTTOM OF MILL SOLUTION TANK No. 1 IS IN THE LOWER RIGHT QUADRANT UNDER A PILE OF SOLUTION SEDIMENT. JOISTS OF TANK No. 2 ARE ABOVE AND SLIGHTLY LEFT OF No. 1. THE BOTTOM OF THE MILL SOLUTION SURGE TANK WITH ATTACHED DISCHARGE PIPE IS VISIBLE ON LOWER RIGHT HAND EDGE OF VIEW; TANKS ORIGINALLY SAT ON DIAGONAL BEAM CUTTING ACROSS UPPER LEFT CORNER OF VIEW. DISCHARGE LAUNDER FROM THE UNOXIDIZED ORE CIRCUIT PIERCES THE FOUNDATION WALL ABOVE TANK No. 1 (FOR DETAIL SEE SD-2-61). - Bald Mountain Gold Mill, Nevada Gulch at head of False Bottom Creek, Lead, Lawrence County, SD

  17. Spontaneous hepatic rupture in pregnancy.

    PubMed

    Nelson, E W; Archibald, L; Albo, D

    1977-12-01

    Hepatic rupture as a late complication of toxemic pregnancy is a rare yet lethal condition requiring rapid recognition and surgical management. The clinical triad of toxemia, right upper quadrant pain, and sudden hypotension is the diagnostic hallmark of presentation. Most patients present near the time of delivery and are found to have subcapsular hematomas of the right hepatic lobe with free rupture into the peritoneal cavity and resultant exsanguinating hemorrhage. The association of toxemia and disseminated intravascular coagulation with secondary microembolic damage to the liver and other organs has been discussed. Basic surgical principles in the managment of hepatic subcapsular hematomas, and the prolonged postoperative course and frequent complications in these patients have been stressed.

  18. Neck and Upper Limb Dysfunction in Patients following Neck Dissection: Looking beyond the Shoulder.

    PubMed

    Gane, Elise M; O'Leary, Shaun P; Hatton, Anna L; Panizza, Benedict J; McPhail, Steven M

    2017-10-01

    Objective To measure patient-perceived upper limb and neck function following neck dissection and to investigate potential associations between clinical factors, symptoms, and function. Study Design Cross-sectional. Setting Two tertiary hospitals in Brisbane, Australia. Subjects and Methods Inclusion criteria: patients treated with neck dissection (2009-2014). aged <18 years, accessory nerve or sternocleidomastoid sacrifice, previous neck dissection, preexisting shoulder/neck injury, and inability to provide informed consent (cognition, insufficient English). Primary outcomes were self-reported function of the upper limb (Quick Disabilities of the Arm, Shoulder, and Hand) and neck (Neck Disability Index). Secondary outcomes included demographics, oncological management, self-efficacy, and pain. Generalized linear models were prepared to examine relationships between explanatory variables and self-reported function. Results Eighty-nine participants (male n = 63, 71%; median age, 62 years; median 3 years since surgery) reported mild upper limb and neck dysfunction (median [quartile 1, quartile 3] scores of 11 [3, 32] and 12 [4, 28], respectively). Significant associations were found between worse upper limb function and longer time since surgery (coefficient, 1.76; 95% confidence interval [CI], 0.01-3.51), having disease within the thyroid (17.40; 2.37-32.44), postoperative radiation therapy (vs surgery only) (13.90; 6.67-21.14), and shoulder pain (0.65; 0.44-0.85). Worse neck function was associated with metastatic cervical lymph nodes (coefficient, 6.61; 95% CI, 1.14-12.08), shoulder pain (0.19; 0.04-0.34), neck pain (0.34; 0.21-0.47), and symptoms of neuropathic pain (0.61; 0.25-0.98). Conclusion Patients can experience upper limb and neck dysfunction following nerve-preserving neck dissection. The upper quadrant as a whole should be considered when assessing rehabilitation priorities after neck dissection.

  19. Reflection of the State of Hunger in Impulse Activity of Nose Wing Muscles and Upper Esophageal Sphincter during Search behavior in Rabbits.

    PubMed

    Kromin, A A; Dvoenko, E E; Zenina, O Yu

    2016-07-01

    Reflection of the state of hunger in impulse activity of nose wing muscles and upper esophageal sphincter muscles was studied in chronic experiments on rabbits subjected to 24-h food deprivation in the absence of locomotion and during search behavior. In the absence of apparent behavioral activity, including sniffing, alai nasi muscles of hungry rabbits constantly generated bursts of action potentials synchronous with breathing, while upper esophageal sphincter muscles exhibited regular aperiodic low-amplitude impulse activity of tonic type. Latent form of food motivation was reflected in the structure of temporal organization of impulse activity of alai nasi muscles in the form of bimodal distribution of interpulse intervals and in temporal structure of impulse activity of upper esophageal sphincter muscles in the form of monomodal distribution. The latent form of food motivation was manifested in the structure of temporal organization of periods of the action potentials burst-like rhythm, generated by alai nasi muscles, in the form of monomodal distribution, characterized by a high degree of dispersion of respiratory cycle periods. In the absence of physical activity hungry animals sporadically exhibited sniffing activity, manifested in the change from the burst-like impulse activity of alai nasi muscles to the single-burst activity type with bimodal distribution of interpulse intervals and monomodal distribution of the burst-like action potentials rhythm periods, the maximum of which was shifted towards lower values, which was the cause of increased respiratory rate. At the same time, the monomodal temporal structure of impulse activity of the upper esophageal sphincter muscles was not changed. With increasing food motivation in the process of search behavior temporal structure of periods of the burst-like action potentials rhythm, generated by alai nasi muscles, became similar to that observed during sniffing, not accompanied by animal's locomotion, which is typical for the increased respiratory rhythm frequency. Increased hunger motivation was reflected in the temporal structure of impulse activity of upper esophageal sphincter muscles in the form of a shift to lower values of the maximum of monomodal distribution of interpulse intervals on the histogram, resulting in higher impulse activity frequency. The simultaneous increase in the frequency of action potentials bursts generation by alai nasi muscles and regular impulse activity of upper esophageal sphincter muscles is a reliable criterion for enhanced food motivation during search behavior in rabbits.

  20. MARK’s Quadrant scoring system: a symptom-based targeted screening tool for gastric cancer

    PubMed Central

    Tata, Mahadevan D.; Gurunathan, Ramesh; Palayan, Kandasami

    2014-01-01

    Background Gastric cancer is notably one of the leading causes of cancer-related death in the world. In Malaysia, these patients present in the advanced stage, thus narrowing the treatment options and making the surgery nearly impossible for successful curative resection. Failure to identify high-risk patients and delay in diagnostic endoscope procedure contributed to the delay in diagnosis. The aim of the study was to develop and validate a scoring system (MARK’s Quadrant) which can identify symptomatic patients who are at risk for gastric cancer. Methods A 3-phase approach was undertaken: Phase 1: development of the weighted scoring system; Phase 2: estimating positive predicting value of MARK’s Quadrant; and Phase 3: a) testing the validity of MARK’s Quadrant in an open-access endoscope system; and b) comparing its usefulness compared to conventional referral system. Results In phases 1 and 2, MARK’s Quadrant with weighted symptoms was developed. The sensitivity of MARK’s Quadrant is 88% and the specificity is 45.5% to detect cancerous and precancerous lesions of gastric. This was confirmed by the prospective data from phase 3 of this study where the diagnostic yield of MARK’s Quadrant to detect any pathological lesion was 95.2%. This score has a high accuracy efficiency of 75%, hence comparing to routine referral system it has an odds ratio (95%CI) of 10.98 (4.63-26.00), 6.71 (4.46-10.09) and 0.95 (0.06-0.15) (P<0.001 respectively) for cancer, precancerous lesion and benign lesion diagnosis respectively. Conclusion MARK’s Quadrant is a useful tool to detect early gastric cancer among symptomatic patients in a low incidence region. PMID:24714557

  1. Ocular anatomy, ganglion cell distribution and retinal resolution of a killer whale (Orcinus orca).

    PubMed

    Mass, Alla M; Supin, Alexander Y; Abramov, Andrey V; Mukhametov, Lev M; Rozanova, Elena I

    2013-01-01

    Retinal topography, cell density and sizes of ganglion cells in the killer whale (Orcinus orca) were analyzed in retinal whole mounts stained with cresyl violet. A distinctive feature of the killer whale's retina is the large size of ganglion cells and low cell density compared to terrestrial mammals. The ganglion cell diameter ranged from 8 to 100 µm, with the majority of cells within a range of 20-40 µm. The topographic distribution of ganglion cells displayed two spots of high cell density located in the temporal and nasal quadrants, 20 mm from the optic disk. The high-density areas were connected by a horizontal belt-like area passing below the optic disk of the retina. Peak cell densities in these areas were evaluated. Mean peak cell densities were 334 and 288 cells/mm(2) in the temporal and nasal high-density areas, respectively. With a posterior nodal distance of 19.5 mm, these high-density data predict a retinal resolution of 9.6' (3.1 cycles/deg.) and 12.6' (2.4 cycles/deg.) in the temporal and nasal areas, respectively, in water. Copyright © 2012 S. Karger AG, Basel.

  2. Assessing posterior ocular structures in β-thalassemia minor.

    PubMed

    Arifoglu, Hasan Basri; Kucuk, Bekir; Duru, Necati; Altunel, Orhan; Gulhan, Ahmet; Ozen, Mustafa; Aygun, Bilal; Atas, Mustafa

    2018-02-01

    The aim of this study was to investigate the effect of β-thalassemia minor on choroidal, macular, and peripapillary retinal nerve fiber layer thickness. To form the sample, we recruited 40 patients with β-thalassemia minor and 44 healthy participants. We used spectral-domain optical coherence tomography to take all measurements of ocular thickness, as well as measured intraocular pressure, axial length, and central corneal thickness. We later analyzed correlations of hemoglobin levels with ocular parameters. A statistically significant difference emerged between patients with β-thalassemia minor and the healthy controls in terms of mean values of subfoveal, nasal, and temporal choroidal thickness (p = 0.001, p = 0.016, and p = 0.010, respectively). Except for central macular thickness, differences in paracentral macular thicknesses between the groups were also significant (superior: p < 0.001, inferior: p = 0.007, temporal: p = 0.001, and nasal: p = 0.005). Also, no statistically significant differences were noted for retinal nerve fiber layer thickness between two groups. Mean values of subfoveal, nasal, temporal choroidal, and macular thickness for the four quadrants were significantly lower in patients with β-thalassemia minor than in healthy controls.

  3. Optical designs for MWIR and four quadrant detectors by using beam steering methods in missile applications

    NASA Astrophysics Data System (ADS)

    Sakarya, Doǧan Uǧur

    2017-10-01

    Beam steering optical arrangement needs less volume envelope for same field of regard than other gimbal approaches. Both for imaging and four quadrant missile applications, volume is critical parameter limiting system performance. Therefore, a conceptual design of beam steering method has been focused on both imaging and four quadrant missiles. In this study; four different optical designs have been made by using both beam steering and regular method for mid-wave infra-red imaging and four quadrant systems. Optical designs performances have been illustrated in simulation results. By using manufactured Risley prisms, some experimental results are conducted to compare simulations results.

  4. Left hepatic lobe herniation through an incisional anterior abdominal wall hernia and right adrenal myelolipoma: a case report and review of the literature.

    PubMed

    Nuño-Guzmán, Carlos M; Arróniz-Jáuregui, José; Espejo, Ismael; Valle-González, Jesús; Butus, Hernán; Molina-Romo, Alejandro; Orranti-Ortega, Rodrigo I

    2012-01-10

    Herniation of the liver through an anterior abdominal wall hernia defect is rare. To the best of our knowledge, only three cases have been described in the literature. A 70-year-old Mexican woman presented with a one-week history of right upper quadrant abdominal pain, nausea, vomiting, and jaundice to our Department of General Surgery. Her medical history included an open cholecystectomy from 20 years earlier and excessive weight. She presented with jaundice, abdominal distension with a midline surgical scar, right upper quadrant tenderness, and a large midline abdominal wall defect with dullness upon percussion and protrusion of a large, tender, and firm mass. The results of laboratory tests were suggestive of cholestasis. Ultrasound revealed choledocholithiasis. A computed tomography scan showed a protrusion of the left hepatic lobe through the anterior abdominal wall defect and a well-defined, soft tissue density lesion in the right adrenal topography. An endoscopic common bile duct stone extraction was unsuccessful. During surgery, the right adrenal tumor was resected first. The hernia was approached through a median supraumbilical incision; the totality of the left lobe was protruding through the abdominal wall defect, and once the lobe was reduced to its normal position, a common bile duct surgical exploration with multiple stone extraction was performed. Finally, the abdominal wall was reconstructed. Histopathology revealed an adrenal myelolipoma. Six months after the operation, our patient remains in good health. The case of liver herniation through an incisional anterior abdominal wall hernia in this report represents, to the best of our knowledge, the fourth such case reported in the literature. The rarity of this medical entity makes it almost impossible to specifically describe predisposing risk factors for liver herniation. Obesity, the right adrenal myelolipoma mass effect, and the previous abdominal surgery are likely to have contributed to incisional hernia formation.

  5. Case history of magnetic bearing supported hot gas turboexpander

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

    Destombes, Y.; Allaire, P.E.

    1995-12-31

    A very significant advantage for the use of magnetic bearings in hot gas and cryogenic expanders is that the bearing operating temperature can be much higher or lower than for conventional oil lubricated fluid film or rolling element bearings. This has lead to the increasing development of industrial expanders which are magnetic bearing supported and rather complex bearing oil supply sealing arrangements can be eliminated. As advances in magnetic bearing technology and understanding occur, the design and performance of the magnetic bearings continues to improve. The purpose of this paper is to describe some characteristics of industrial magnetic bearing supportedmore » turboexpanders, both hot gas and cryogenic, and present a particular hot gas expander application. This paper discusses the basic principles of operation of the magnetic bearings including the bearing radial and thrust bearings, sensors, control system, and dynamic characteristics. The governing equations are given for upper quadrant radial bearing designs. Design equations relevant to bearing design will be presented to assist potential users of magnetic bearings in understanding their operation. The paper also presents a practical application of magnetic bearings to a hot gas turbogenerator. The bearings support a turbine wheel which converts the exhaust gas energy of a blast furnace into electrical power through a synchronous 6 MW generator. The magnetic bearing allowed the rotor to be constructed as a single shaft machine. The turbine wheel is directly connected to the generator rotor. The unit has been successfully operated for a 8 year period and now has in excess of 70,000 hours in a steel plant in Europe. It has some unique features: (1) it is the heaviest magnetic bearing supported rotor in industrial operation at 8 tons, (2) it has very high unbalance acceptance, (3) it has a special rotor mounted auxiliary bearing design, and (4) only the upper quadrant of the bearing is employed in the unit.« less

  6. The influence of the magnetic field on running penumbral waves in the solar chromosphere

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

    Jess, D. B.; Reznikova, V. E.; Van Doorsselaere, T.

    2013-12-20

    We use images of high spatial and temporal resolution, obtained using both ground- and space-based instrumentation, to investigate the role magnetic field inclination angles play in the propagation characteristics of running penumbral waves in the solar chromosphere. Analysis of a near-circular sunspot, close to the center of the solar disk, reveals a smooth rise in oscillatory period as a function of distance from the umbral barycenter. However, in one directional quadrant, corresponding to the north direction, a pronounced kink in the period-distance diagram is found. Utilizing a combination of the inversion of magnetic Stokes vectors and force-free field extrapolations, wemore » attribute this behavior to the cut-off frequency imposed by the magnetic field geometry in this location. A rapid, localized inclination of the magnetic field lines in the north direction results in a faster increase in the dominant periodicity due to an accelerated reduction in the cut-off frequency. For the first time, we reveal how the spatial distribution of dominant wave periods, obtained with one of the highest resolution solar instruments currently available, directly reflects the magnetic geometry of the underlying sunspot, thus opening up a wealth of possibilities in future magnetohydrodynamic seismology studies. In addition, the intrinsic relationships we find between the underlying magnetic field geometries connecting the photosphere to the chromosphere, and the characteristics of running penumbral waves observed in the upper chromosphere, directly supports the interpretation that running penumbral wave phenomena are the chromospheric signature of upwardly propagating magneto-acoustic waves generated in the photosphere.« less

  7. Determinants of peripapillary retinal nerve fiber layer thickness regarding ocular and systemic parameters - the MIPH Eye&Health Study.

    PubMed

    Schuster, Alexander Karl-Georg; Fischer, Joachim Ernst; Vossmerbaeumer, Christine; Vossmerbaeumer, Urs

    2016-10-01

    Optical coherence tomography (OCT) allows quantitative image analysis of retinal tissue in vivo. Peripapillary retinal nerve fiber layer (pRNFL) thickness is widely used for evaluation of retinal nerve fiber rarefaction in several optic neuropathies. This study evaluates associations of pRNFL thickness in healthy adult subjects in order to evaluate influencing factors. A cross-sectional study was performed in a working-age population. Only eyes without detectable ocular pathologies were included in the analysis. Among analyzed systemic cardiovascular parameters were age, gender, body-mass index, mean arterial blood pressure, HbA1c, high- and low-density-lipoproteins, and triglycerides. A comprehensive ophthalmological examination including refraction, tonometry, keratometry, and central corneal thickness measurmentwas performed. In addition, pRNFL thickness was imaged by spectral-domain OCT. Univariable and multivariable associations of pRNFL thickness in all four quadrants and on average with systemic and ocular parameters were calculated using a generalized estimating equation model. Three hundred and six subjects were included. pRNFL thickness measurements showed a significant association with spherical equivalent: pRNFL thickness decreased with increasing myopia in all quadrants (multivariable regression coefficients Beta: superior: 1.16, 95 % CI [0.62;1.71], p < 0.001; temporal: 0.87, [0.33;1.41], p = 0.001; inferior: 1.80, [1.18;2.42], p < 0.001; nasal: 2.60, [2.01;3.20], p < 0.001) and on average (1.51, [1.20;1.82], p < 0.001). A thicker central cornea thickness was related to lower pRNFL in the superior (-0.05, [-0.10; -0.01], p = 0.01), the inferior quadrant (-0.05, [-0.10;0.00], p = 0.03) and on average (-0.04, [-0.07; -0.01], p = 0.02). All other parameters were not  associated. Our findings highlight the importance of refraction when evaluating pRNFL thickness and its independence from other systemic parameters.

  8. Histopathology of tympanic membranes from patients with ventilation tubes.

    PubMed

    Oktay, Mehmet Faruk; Tansuker, Hasan Deniz; Fukushima, Hisaki; Paparella, Michael M; Schachern, Patricia A; Cureoglu, Sebahattin

    2018-06-01

    To evaluate the histopathologic changes in tympanic membranes (TMs) with ventilation tubes (VTs). In this retrospective human temporal bone study our overall study group included 4 subgroups of TMs from deceased donors as follows: 24 with a history of VT insertion for chronic otitis media with effusion (COME-VT); 5 with a history of VT insertion for Meniere's disease (MD-VT); 33 without a history of VT insertion for chronic otitis media with effusion (COME); and 14 without a history of VT insertion for Meniere's disease (MD). We classified the extent of migration of the outer keratinized squamous epithelium onto the inner surface of TM perforations and noted the presence and location of tympanosclerosis, of atrophy, of perforation, and/or of cholesteatoma formation. Tympanosclerosis occurred in 14/24 TMs in the COME-VT subgroup; 2/5, MD-VT; 7/33, COME; and 0/14, MD. The VT insertion site was mostly in the anteroinferior (63%) quadrant of the TM; tympanosclerosis occurred more frequently in the posteroinferior (42%) and posterosuperior (33%) quadrants. We found no significant correlation between the location of tympanosclerosis and the VT insertion site (P>0.05). Atrophy occurred in 7/24 TMs in the COME-VT subgroup; 3/5, MD-VT; 8/33, COME; and 2/14, MD. We found no significant correlation between the location of atrophy and the VT insertion site; however, atrophy was located mostly in the anteroinferior quadrant (one of the most common VT insertion sites) of the TM. Regarding the ingrowth of keratinized epithelium, the mucocutanous junction was detected at any point at the inner surface of the TM in 50% of the specimens. We observed intratympanic cholesteatoma formation in 2/24 TMs in the COME-VT subgroup. TM changes due to VT insertion are more common than previously realized. Meticulous otomicroscopic evaluation of the TM is necessary during tympanomastoidectomies in order to prevent the intratympanic inclusion pearls and squamous epithelial ingrowth to prevent any further cholesteatoma formation. Copyright © 2017. Published by Elsevier B.V.

  9. CapDEM TD - Modeling and Simulation (Role and Tools) State of the Art Report

    DTIC Science & Technology

    2005-01-01

    office/wcm1/ornclinfn/ciefilnlt rnsnx [55] http://www.idefine.com/Tutorial/TutOiial%20Sales%20Page.htm [56] Gartner , " Magic Quadrant for Business ...21 Figure 3-5: Gartner Magic Quadrant For BPA, 2004 (56...of January 2004 Niche Players Visionaries ------- Completeness of Vision ..., Figure 3-5: Gartner Magic Quadrant For BPA, 2004 [56] Gartner , Inc

  10. Type V hypertriglyceridemia in children, a therapeutic challenge in pediatrics

    PubMed Central

    Mărginean, Cristina Oana; Meliţ, Lorena Elena; Dobreanu, Minodora; Mărginean, Maria Oana

    2017-01-01

    Abstract Rationale: Hypertriglyceridemia is defined as a level of triglycerides above 150 mg/dL. The complex causes and classification of hypertriglyceridemia lead to difficulties in the diagnosis and management of this condition. Patient concerns: We present the case of a 15 years and 6 months old female teenager, admitted in our clinic for the following complaints: severe abdominal pain predominantly in the lateral left quadrant, nausea, vomiting, and the lack of stools for 2 days. The clinical exam showed: impaired general status, painful abdomen at superficial and deep palpation in the left and upper abdominal quadrants, the absence of stools for 2 days. Diagnoses: The laboratory parameters revealed leukocytosis with neutrophilia, thrombocytopenia, high level of serum amylase and triglycerides, and increased inflammatory biomarkers. The imagistic investigations showed ascites and paralytic ileus. Interventions: The management was burdened by the side-effects of hypolipidemic drugs impairing the liver function and leading to rhabdomyolysis, but eventually the patient's outcome was good. Outcomes: Type V hyperlipoproteinemia is a rare condition accounting for approximately 5% of the cases. The risk for acute pancreatitis is well-known to be associated with hypertriglyceridemia, even though in rare cases. Lessons: The prognosis of hypertriglyceridemia is pediatrics is burdened not only by the long-term risk factors associated to the diseases itself, but also by the negative effects of long-term hypolipidemic treatment. PMID:29390422

  11. A survey on the utilization of disposable quadrant articulators.

    PubMed

    Thornton, Linda J

    2002-01-01

    This study evaluated utilization of the six most popular disposable quadrant articulators presently used in crown fabrication. Most general practitioners and crown and bridge laboratory technicians reported that they frequently or always used disposable quadrant articulators for single units and simple three-unit fixed partial dentures. All evaluated articulators demonstrated an inability to maintain and repeat the centric stop position. The disposable quadrant articulator, used in combination with dual-arch impressions, is a viable method for fabricating single and short-span restorations. While a nonrepeatable centric stop was present in all six articulators evaluated, the method was considered a time-efficient and cost-saving alternative to traditional all-metal simple-hinge articulators.

  12. Deep Temporal Nerve Transfer for Facial Reanimation: Anatomic Dissections and Surgical Case Report.

    PubMed

    Mahan, Mark A; Sivakumar, Walavan; Weingarten, David; Brown, Justin M

    2017-09-08

    Facial nerve palsy is a disabling condition that may arise from a variety of injuries or insults and may occur at any point along the nerve or its intracerebral origin. To examine the use of the deep temporal branches of the motor division of the trigeminal nerve for neural reconstruction of the temporal branches of the facial nerve for restoration of active blink and periorbital facial expression. Formalin-fixed human cadaver hemifaces were dissected to identify landmarks for the deep temporal branches and the tension-free coaptation lengths. This technique was then utilized in 1 patient with a history of facial palsy due to a brainstem cavernoma. Sixteen hemifaces were dissected. The middle deep temporal nerve could be consistently identified on the deep side of the temporalis, within 9 to 12 mm posterior to the jugal point of the zygoma. From a lateral approach through the temporalis, the middle deep temporal nerve could be directly coapted to facial temporal branches in all specimens. Our patient has recovered active and independent upper facial muscle contraction, providing the first case report of a distinct distal nerve transfer for upper facial function. The middle deep temporal branches can be readily identified and utilized for facial reanimation. This technique provided a successful reanimation of upper facial muscles with independent activation. Utilizing multiple sources for neurotization of the facial muscles, different potions of the face can be selectively reanimated to reduce the risk of synkinesis and improved control. Copyright © 2017 by the Congress of Neurological Surgeons

  13. Quadrant CFD Analysis of a Mixer-Ejector Nozzle for HSCT Applications

    NASA Technical Reports Server (NTRS)

    Yoder, Dennis A.; Georgiadis, Nicholas J.; Wolter, John D.

    2005-01-01

    This study investigates the sidewall effect on flow within the mixing duct downstream of a lobed mixer-ejector nozzle. Simulations which model only one half-chute width of the ejector array are compared with those which model one complete quadrant of the nozzle geometry and with available experimental data. These solutions demonstrate the applicability of the half-chute technique to model the flowfield far away from the sidewall and the necessity of a full-quadrant simulation to predict the formation of a low-energy flow region near the sidewall. The quadrant solutions are further examined to determine the cause of this low-energy region, which reduces the amount of mixing and lowers the thrust of the nozzle. Grid resolution and different grid topologies are also examined. Finally, an assessment of the half-chute and quadrant approaches is made to determine the ability of these simulations to provide qualitative and/or quantitative predictions for this type of complex flowfield.

  14. Interarticulator coordination in children with and without cerebral palsy

    PubMed Central

    Nip, Ignatius S. B.

    2017-01-01

    The current study investigates how interarticulator coordination changes across speaking tasks varying in articulatory and linguistic demands for children with CP and their typically-developing peers. Articulatory movements from 12 children with spastic CP (7M, 5F, 4–15 years of age) and 12 typically-developing age- and sex-matched peers were cross-correlated to determine the degree of spatial and temporal coupling between the upper lip and jaw, lower lip and jaw, and upper and lower lips. Spatial and temporal coupling were also correlated with intelligibility. Results indicated that children with CP have reduced spatial coupling between the upper and lower lips and reduced temporal coupling between all articulators as compared to their typically-developing peers. For all participants, sentences were produced with the greatest degree of interarticulator coordination when compared to the diadochokinetic and syllable repetition tasks. Measures of interarticulator coordination were correlated with intelligibility for the speakers with CP. PMID:25905558

  15. Visualisation of upper limb activity using spirals: A new approach to the assessment of daily prosthesis usage.

    PubMed

    Chadwell, Alix; Kenney, Laurence; Granat, Malcolm; Thies, Sibylle; Head, John S; Galpin, Adam

    2018-02-01

    Current outcome measures used in upper limb myoelectric prosthesis studies include clinical tests of function and self-report questionnaires on real-world prosthesis use. Research in other cohorts has questioned both the validity of self-report as an activity assessment tool and the relationship between clinical functionality and real-world upper limb activity. Previously, 1 we reported the first results of monitoring upper limb prosthesis use. However, the data visualisation technique used was limited in scope. Methodology development. To introduce two new methods for the analysis and display of upper limb activity monitoring data and to demonstrate the potential value of the approach with example real-world data. Upper limb activity monitors, worn on each wrist, recorded data on two anatomically intact participants and two prosthesis users over 1 week. Participants also filled in a diary to record upper limb activity. Data visualisation was carried out using histograms, and Archimedean spirals to illustrate temporal patterns of upper limb activity. Anatomically intact participants' activity was largely bilateral in nature, interspersed with frequent bursts of unilateral activity of each arm. At times when the prosthesis was worn prosthesis users showed very little unilateral use of the prosthesis (≈20-40 min/week compared to ≈350 min/week unilateral activity on each arm for anatomically intact participants), with consistent bias towards the intact arm throughout. The Archimedean spiral plots illustrated participant-specific patterns of non-use in prosthesis users. The data visualisation techniques allow detailed and objective assessment of temporal patterns in the upper limb activity of prosthesis users. Clinical relevance Activity monitoring offers an objective method for the assessment of upper limb prosthesis users' (PUs) activity outside of the clinic. By plotting data using Archimedean spirals, it is possible to visualise, in detail, the temporal patterns of upper limb activity. Further work is needed to explore the relationship between traditional functional outcome measures and real-world prosthesis activity.

  16. The phonatory deviation diagram: a novel objective measurement of vocal function.

    PubMed

    Madazio, Glaucya; Leão, Sylvia; Behlau, Mara

    2011-01-01

    To identify the discriminative characteristics of the phonatory deviation diagram (PDD) in rough, breathy and tense voices. One hundred and ninety-six samples of normal and dysphonic voices from adults were submitted to perceptual auditory evaluation, focusing on the predominant vocal quality and the degree of deviation. Acoustic analysis was performed with the VoxMetria (CTS Informatica). Significant differences were observed between the dysphonic and normal groups (p < 0.001), and also between the breathy and rough samples (p = 0.044) and the breathy and tense samples (p < 0.001). All normal voices were positioned in the inferior left quadrant, 45% of the rough voices in the inferior right quadrant, 52.6% of the breathy voices in the superior right quadrant and 54.3% of the tense voices in the inferior left quadrant of the PDD. In the inferior left quadrant, 93.8% of voices with no deviation were located and 72.7% of voices with mild deviation; voices with moderate deviation were distributed in the inferior and superior right quadrants, the latter ones containing the most deviant voices and 80% of voices with severe deviation. The PDD was able to discriminate normal from dysphonic voices, and the distribution was related to the type and degree of voice alteration. Copyright © 2011 S. Karger AG, Basel.

  17. Conduction velocity of the uterine contraction in serial magnetomyogram (MMG) data: event based simulation and validation.

    PubMed

    Furdea, Adrian; Preissl, Hubert; Lowery, Curtis L; Eswaran, Hari; Govindan, Rathinaswamy B

    2011-01-01

    We propose a novel approach to calculate the conduction velocity (CV) of the uterine contraction bursts in magnetomyogram (MMG) signals measured using a multichannel SQUID array. For this purpose, we partition the sensor coordinates into four different quadrants and identify the contractile bursts using a previously proposed Hilbert-wavelet transform approach. If contractile burst is identified in more than one quadrant, we calculate the center of gravity (CoG) in each quadrant for each time point as the sum of the product of the sensor coordinates with the Hilbert amplitude of the MMG signals normalized by the sum of the Hilbert amplitude of the signals over all sensors. Following this we compute the delay between the CoGs of all (six) possible quadrant pairs combinations. As a first step, we validate this approach by simulating a stochastic model based on independent second-order autoregressive processes (AR2) and we divide them into 30 second disjoint windows and insert burst activity at specific time instances in preselected sensors. Also we introduce a lag of 5 ± 1 seconds between different quadrants. Using our approach we calculate the CoG of the signals in a quadrant. To this end, we compute the delay between CoGs obtained from different quadrants and show that our approach is able to reliably capture the delay incorporated in the model. We apply the proposed approach to 19 serial MMG data obtained from two subjects and show an increase in the CV as the subjects approached labor.

  18. Applying the balanced scorecard to local public health performance measurement: deliberations and decisions

    PubMed Central

    Weir, Erica; d'Entremont, Nadine; Stalker, Shelley; Kurji, Karim; Robinson, Victoria

    2009-01-01

    Background All aspects of the heath care sector are being asked to account for their performance. This poses unique challenges for local public health units with their traditional focus on population health and their emphasis on disease prevention, health promotion and protection. Reliance on measures of health status provides an imprecise and partial picture of the performance of a health unit. In 2004 the provincial Institute for Clinical Evaluative Sciences based in Ontario, Canada introduced a public-health specific balanced scorecard framework. We present the conceptual deliberations and decisions undertaken by a health unit while adopting the framework. Discussion Posing, pondering and answering key questions assisted in applying the framework and developing indicators. Questions such as: Who should be involved in developing performance indicators? What level of performance should be measured? Who is the primary intended audience? Where and how do we begin? What types of indicators should populate the health status and determinants quadrant? What types of indicators should populate the resources and services quadrant? What type of indicators should populate the community engagement quadrant? What types of indicators should populate the integration and responsiveness quadrants? Should we try to link the quadrants? What comparators do we use? How do we move from a baseline report card to a continuous quality improvement management tool? Summary An inclusive, participatory process was chosen for defining and creating indicators to populate the four quadrants. Examples of indicators that populate the four quadrants of the scorecard are presented and key decisions are highlighted that facilitated the process. PMID:19426508

  19. Applying the balanced scorecard to local public health performance measurement: deliberations and decisions.

    PubMed

    Weir, Erica; d'Entremont, Nadine; Stalker, Shelley; Kurji, Karim; Robinson, Victoria

    2009-05-08

    All aspects of the heath care sector are being asked to account for their performance. This poses unique challenges for local public health units with their traditional focus on population health and their emphasis on disease prevention, health promotion and protection. Reliance on measures of health status provides an imprecise and partial picture of the performance of a health unit. In 2004 the provincial Institute for Clinical Evaluative Sciences based in Ontario, Canada introduced a public-health specific balanced scorecard framework. We present the conceptual deliberations and decisions undertaken by a health unit while adopting the framework. Posing, pondering and answering key questions assisted in applying the framework and developing indicators. Questions such as: Who should be involved in developing performance indicators? What level of performance should be measured? Who is the primary intended audience? Where and how do we begin? What types of indicators should populate the health status and determinants quadrant? What types of indicators should populate the resources and services quadrant? What type of indicators should populate the community engagement quadrant? What types of indicators should populate the integration and responsiveness quadrants? Should we try to link the quadrants? What comparators do we use? How do we move from a baseline report card to a continuous quality improvement management tool? An inclusive, participatory process was chosen for defining and creating indicators to populate the four quadrants. Examples of indicators that populate the four quadrants of the scorecard are presented and key decisions are highlighted that facilitated the process.

  20. Examining the Angular Resolution of the Astro-H's Soft X-Ray Telescopes

    NASA Technical Reports Server (NTRS)

    Sato, Toshiki; Iizuka, Ryo; Ishida, Manabu; Kikuchi, Naomichi; Maeda, Yoshitomo; Kurashima, Sho; Nakaniwa, Nozomi; Tomikawa, Kazuki; Hayashi, Takayuki; Mori, Hideyuki; hide

    2016-01-01

    The international x-ray observatory ASTRO-H was renamed Hitomi after launch. It covers a wide energy range from a few hundred eV to 600 keV. It is equipped with two soft x-ray telescopes (SXTs: SXT-I and SXT-S) for imaging the soft x-ray sky up to 12 keV, which focus an image onto the respective focal-plane detectors: CCD camera (SXI) and a calorimeter (SXS). The SXTs are fabricated in a quadrant unit. The angular resolution in half-power diameter (HPD) of each quadrant of the SXTs ranges between 1.1 and 1.4 arc min at 4.51 keV. It was also found that one quadrant has an energy dependence on the HPD. We examine the angular resolution with spot scan measurements. In order to understand the cause of imaging capability deterioration and to reflect it to the future telescope development, we carried out spot scan measurements, in which we illuminate all over the aperture of each quadrant with a square beam 8 mm on a side. Based on the scan results, we made maps of image blurring and a focus position. The former and the latter reflect figure error and positioning error, respectively, of the foils that are within the incident 8 mm x 8 mm beam. As a result, we estimated those errors in a quadrant to be approx. 0.9 to 1.0 and approx. 0.6 to 0.9 arc min, respectively. We found that the larger the positioning error in a quadrant is, the larger its HPD is. The HPD map, which manifests the local image blurring, is very similar from quadrant to quadrant, but the map of the focus position is different from location to location in each telescope. It is also found that the difference in local performance causes energy dependence of the HPD.

  1. Behavioral biases when viewing multiplexed scenes: scene structure and frames of reference for inspection

    PubMed Central

    Stainer, Matthew J.; Scott-Brown, Kenneth C.; Tatler, Benjamin W.

    2013-01-01

    Where people look when viewing a scene has been a much explored avenue of vision research (e.g., see Tatler, 2009). Current understanding of eye guidance suggests that a combination of high and low-level factors influence fixation selection (e.g., Torralba et al., 2006), but that there are also strong biases toward the center of an image (Tatler, 2007). However, situations where we view multiplexed scenes are becoming increasingly common, and it is unclear how visual inspection might be arranged when content lacks normal semantic or spatial structure. Here we use the central bias to examine how gaze behavior is organized in scenes that are presented in their normal format, or disrupted by scrambling the quadrants and separating them by space. In Experiment 1, scrambling scenes had the strongest influence on gaze allocation. Observers were highly biased by the quadrant center, although physical space did not enhance this bias. However, the center of the display still contributed to fixation selection above chance, and was most influential early in scene viewing. When the top left quadrant was held constant across all conditions in Experiment 2, fixation behavior was significantly influenced by the overall arrangement of the display, with fixations being biased toward the quadrant center when the other three quadrants were scrambled (despite the visual information in this quadrant being identical in all conditions). When scenes are scrambled into four quadrants and semantic contiguity is disrupted, observers no longer appear to view the content as a single scene (despite it consisting of the same visual information overall), but rather anchor visual inspection around the four separate “sub-scenes.” Moreover, the frame of reference that observers use when viewing the multiplex seems to change across viewing time: from an early bias toward the display center to a later bias toward quadrant centers. PMID:24069008

  2. Multi-Quadrant Biopsy Technique Improves Diagnostic Ability in Large Heterogeneous Renal Masses.

    PubMed

    Abel, E Jason; Heckman, Jennifer E; Hinshaw, Louis; Best, Sara; Lubner, Meghan; Jarrard, David F; Downs, Tracy M; Nakada, Stephen Y; Lee, Fred T; Huang, Wei; Ziemlewicz, Timothy

    2015-10-01

    Percutaneous biopsy obtained from a single location is prone to sampling error in large heterogeneous renal masses, leading to nondiagnostic results or failure to detect poor prognostic features. We evaluated the accuracy of percutaneous biopsy for large renal masses using a modified multi-quadrant technique vs a standard biopsy technique. Clinical and pathological data for all patients with cT2 or greater renal masses who underwent percutaneous biopsy from 2009 to 2014 were reviewed. The multi-quadrant technique was defined as multiple core biopsies from at least 4 separate solid enhancing areas in the tumor. The incidence of nondiagnostic findings, sarcomatoid features and procedural complications was recorded, and concordance between biopsy specimens and nephrectomy pathology was compared. A total of 122 biopsies were performed for 117 tumors in 116 patients (46 using the standard biopsy technique and 76 using the multi-quadrant technique). Median tumor size was 10 cm (IQR 8-12). Biopsy was nondiagnostic in 5 of 46 (10.9%) standard and 0 of 76 (0%) multi-quadrant biopsies (p=0.007). Renal cell carcinoma was identified in 96 of 115 (82.0%) tumors and nonrenal cell carcinoma tumors were identified in 21 (18.0%). One complication occurred using the standard biopsy technique and no complications were reported using the multi-quadrant technique. Sarcomatoid features were present in 23 of 96 (23.9%) large renal cell carcinomas studied. Sensitivity for identifying sarcomatoid features was higher using the multi-quadrant technique compared to the standard biopsy technique at 13 of 15 (86.7%) vs 2 of 8 (25.0%) (p=0.0062). The multi-quadrant percutaneous biopsy technique increases the ability to identify aggressive pathological features in large renal tumors and decreases nondiagnostic biopsy rates. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  3. The influence of corneal astigmatism on retinal nerve fiber layer thickness and optic nerve head parameter measurements by spectral-domain optical coherence tomography

    PubMed Central

    2012-01-01

    Background To evaluate the influence of corneal astigmatism (CA) on retinal nerve fiber layer (RNFL) thickness and optic nerve head(ONH) parameters measured with spectral-domain optical coherence tomography (OCT) in high myopes patients before refractive surgery. Methods Seventy eyes of 35 consecutive refractive surgery candidates were included in this study. The mean age of the subjects was 26.42 ± 6.95 years, the average CA was −1.17 diopters (D; SD 0.64; range −0.2 to-3.3D), All subjects in this study were WTR CA. 34 eyes were in the normal CA group with a mean CA was −0.67 ± 0.28D, 36 eyes were in the high CA group with an average CA of −1.65 ± 0.49D. All subjects underwent ophthalmic examination and imaging with the Cirrus HD OCT. Results No significant difference was noted in the average cup-to-disk ratio, vertical cup-to-disk ratio and cup volume (all P values > 0.05). Compared with the normal CA group, the high CA group had a larger disc area and rim area, thinner RNFL thickness in the temporal quadrant, and the superotemporal and inferotemporal peaks were farther to the temporal horizon (All P values < 0.05). There were no significant differences between the two groups in global average RNFL thickness, as well as superior, nasal and inferior quadrant RNFL thickness (all P values > 0.05). Conclusions The degree of with-the-rule CA should be considered when interpreting ONH parameters and peripapillary RNFL thickness measured by the Cirrus HD OCT. Virtual slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1148475676881895 PMID:22621341

  4. Effects of Implantable Collamer Lens V4c Placement on Iridocorneal Angle Measurements by Fourier-Domain Optical Coherence Tomography.

    PubMed

    Fernández-Vigo, José Ignacio; Macarro-Merino, Ana; Fernández-Vigo, Cristina; Fernández-Vigo, José Ángel; Martínez-de-la-Casa, José María; Fernández-Pérez, Cristina; García-Feijóo, Julián

    2016-02-01

    To assess by Fourier-domain optical coherence tomography (FDOCT) changes produced in iridocorneal angle measurements in patients undergoing Visian Implantable Collamer Lens (ICL) V4c (STAAR Surgical AG) placement. Prospective interventional case series. In 50 eyes of 25 myopic subjects consecutively scheduled for ICL implant, FDOCT (RTVue; Optovue Inc) iridocorneal angle measurements were made before and 1 and 3 months after surgery. Trabecular-iris angle (TIA) and angle opening distance 500 μm anterior to the scleral spur (AOD500) were compared among the quadrants nasal, temporal, and inferior, and correlations with ocular variables including lens vault were examined. Preoperative TIA was 48.7 ± 8.7, 48.2 ± 8.7, and 48.7 ± 9.3 degrees for the nasal, temporal, and inferior quadrants, with no differences (P = 1.000). Following ICL implant, corresponding values fell to 31.2 ± 11.5, 30.0 ± 10.7, and 29.7 ± 8.1 degrees at 1 month postsurgery, indicating angle narrowing of 34%-42%, and to 30.6 ± 12.3, 30.1 ± 11.9, and 29.8 ± 12.3 degrees, respectively, at 3 months postsurgery. Angle measurements failed to vary between 1 month and 3 months postsurgery (P = .481). In 8 eyes, iridotrabecular contact attributable to surgery was observed. One month after surgery, vault measurements correlated with TIA (R = -.309; P = .048). Six variables were identified as predictors of TIA at 1 month postsurgery (R(2) = .907). Although considerable angle narrowing was detected 1 month after ICL V4c implant, this narrowing remained stable at 3 months postsurgery. Factors predictive of TIA could serve to identify suitable candidates for ICL placement. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Relation Between Macular Retinal Ganglion Cell/Inner Plexiform Layer Thickness and Multifocal Electroretinogram Measures in Experimental Glaucoma

    PubMed Central

    Luo, Xunda; Patel, Nimesh B.; Rajagopalan, Lakshmi P.; Harwerth, Ronald S.; Frishman, Laura J.

    2014-01-01

    Purpose. We investigated relations between macular retinal ganglion cell plus inner plexiform layer (RGC+IPL) thickness and macular retinal function revealed by multifocal electroretinonography (mfERG) in a nonhuman primate model of experimental glaucoma. Methods. Retinal ganglion cell (RGC) structure and function were followed with spectral-domain optical coherence tomography (SD-OCT) and ERGs in five macaques with unilateral experimental glaucoma. Linear regression was used to study correlations in control (Con) and experimental (Exp) eyes between peripapillary retinal nerve fiber layer (RNFL) thickness, macular RGC+IPL thickness, multifocal photopic negative response (mfPhNR) and high-frequency multifocal oscillatory potentials (mfOP) in slow-sequence mfERG, and low-frequency component (mfLFC) in global-flash mfERG. We used ANOVA and paired t-tests to compare glaucoma-related mfERG changes between superior and inferior hemifields, foveal hexagon, inner three rings, and four quadrants of macula. Results. Average macular RGC+IPL and temporal RNFL thickness were strongly correlated (r2 = 0.90, P < 0.001). In hexagon-by-hexagon analysis, all three mfERG measures were correlated (P < 0.001) with RGC+IPL thickness for Con (r2, 0.33–0.51) and Exp eyes (r2, 0.17–0.35). The RGC structural and functional metrics decreased as eccentricity increased. The reduction in amplitude of mfERG measures in Exp eyes relative to Con eyes was proportionally greater, in general, than the relative thinning of RGC+IPL at the same location for eyes in which structural loss was not evident, or mild to moderate. Although not statistically significant, percent amplitude reduction of mfERG measures was greatest in the inferior temporal quadrant. Conclusions. Macular RGC+IPL thickness and mfERG measures of RGC function can be complementary tools in assessing glaucomatous neuropathy. PMID:24970256

  6. Clinical presentation of familial exudative vitreoretinopathy.

    PubMed

    Ranchod, Tushar M; Ho, Lawrence Y; Drenser, Kimberly A; Capone, Antonio; Trese, Michael T

    2011-10-01

    To describe the clinical characteristics, staging and presentation of patients with familial exudative vitreoretinopathy (FEVR) in our clinical practice over the last 25 years. Case series, retrospective review. We included 273 eyes of 145 patients. Data collected from charts included gender, gestational age at birth, birthweight, age at presentation, referring diagnosis, family history, prior ocular surgery, and clinical presentation in each eye. Eyes with invasive posterior segment procedures before initial presentation were excluded. Demographics on presentation and clinical staging. Patients were slightly male predominant (57%) with a mean birthweight of 2.80 kg (range, 740 g-4.76 kg), mean gestational age of 37.8 weeks (range, 25-42), and mean age at presentation of almost 6 years (range, <1 month-49 years). A positive family history of FEVR was obtained in 18% of patients. A positive family history for ocular disease consistent with but not diagnosed as FEVR was obtained in an additional 19%. Stage 1 FEVR was identified in 45 eyes, stage 2 in 33 eyes, stage 3 in 42 eyes, stage 4 in 89 eyes, and stage 5 in 44 eyes. Radial retinal folds were seen in 77 eyes, 64 of which were temporal or inferotemporal in location. The FEVR patient population is remarkable for the wide range of age at presentation, gestational age, and birthweight. Although a positive family history on presentation may support the diagnosis of FEVR, a negative family history is of little help. The majority of retinal folds extended radially in the temporal quadrants, but radial folds were seen in almost all quadrants. Fellow eyes demonstrated a wide variation in symmetry. The presentation of FEVR may mimic the presentation of other pediatric and adult vitreoretinal disorders, and careful examination is often crucial in making the diagnosis of FEVR. The authors have no proprietary or commercial interest in any of the materials discussed in this article. Copyright © 2011 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  7. Spontaneous Adrenal Hemorrhage in Pregnancy: A Case Series.

    PubMed

    Gupta, Ankita; Minhas, Ruby; Quant, Hayley S

    2017-01-01

    Background . Abdominal pain during pregnancy has a broad differential diagnosis which includes spontaneous adrenal hemorrhage (SAH). There is scant literature available on optimal mode of delivery in stable patients. Cases . Patient 1 was a 35-year-old nullipara who presented at 36 weeks of gestation with left flank pain. Patient 2 was a 27-year-old multipara at 38 weeks who presented with left upper quadrant pain. Diagnosis of SAH was made by CT scan and both were managed with pain control, serial hemoglobin assessments, and abdominal exams resulting in uncomplicated vaginal deliveries. Conclusion . SAH, although rare, is an important consideration when evaluating abdominal and flank pain in pregnancy. Management options vary from conservative management to surgical intervention depending on the stability of the patient.

  8. Spontaneous Adrenal Hemorrhage in Pregnancy: A Case Series

    PubMed Central

    Minhas, Ruby; Quant, Hayley S.

    2017-01-01

    Background. Abdominal pain during pregnancy has a broad differential diagnosis which includes spontaneous adrenal hemorrhage (SAH). There is scant literature available on optimal mode of delivery in stable patients. Cases. Patient 1 was a 35-year-old nullipara who presented at 36 weeks of gestation with left flank pain. Patient 2 was a 27-year-old multipara at 38 weeks who presented with left upper quadrant pain. Diagnosis of SAH was made by CT scan and both were managed with pain control, serial hemoglobin assessments, and abdominal exams resulting in uncomplicated vaginal deliveries. Conclusion. SAH, although rare, is an important consideration when evaluating abdominal and flank pain in pregnancy. Management options vary from conservative management to surgical intervention depending on the stability of the patient. PMID:28421152

  9. [Granulomatous mastitis in a patient treated with prednisone].

    PubMed

    Fetveit, T; Uggerud, R

    1993-09-30

    A 36 year old woman, mother of a two year old child developed, in the course of one night, a tender mass in the upper medial quadrant of the left mamma. Treatment with antibiotics had no effect, and after a week the patient was admitted to hospital for drainage of the abscess and further examination. She had then developed reactive arthritis. Histological examination of a specimen from the mamma revealed lobular granulomatous mastitis. This connection has not been described before in the literature. Further examination showed no signs of infectious disease or sarcoidosis. Surgical drainage had only a minor effect on the breast-mass. The patient was treated with prednisone for six months, and after one year of observation the mass has disappeared, but the arthralgias persists.

  10. Motility and gravitactic orientation of the flagellate, Euglena gracilis, impaired by artificial and solar UV-B radiation.

    PubMed

    Hader, D P; Liu, S M

    1990-09-01

    The effects of ultraviolet radiation on the gravitactic orientation of the freshwater flagellate, Euglena gracilis, were determined by a real time image analysis system. Both artificial UV radiation and solar radiation in a temperature-controlled growth chamber were employed. Histograms of gravitaxis showed that the degree of orientation decreased with increasing exposure time; this can be quantified using the Rayleigh test and upper quadrant summation. The effects of artificial UV radiation on the orientation are considerably stronger than those of solar radiation, probably because the radiation source emits higher fluence rates below 300 nm than found in solar radiation. The effects of monochromatic ultraviolet radiation on motility have been determined, and an action spectrum has been calculated.

  11. Giant gallstone: A case report

    PubMed Central

    Becerra, Pablo; Becerra, Valentina; Aguilar, Christian; Modragon, Itziar; Cooper, David K.C.

    2011-01-01

    Introduction There is a high incidence of gallstones in the Chilean population. Presentation of case We report on a 57-year-old man who complained of abdominal pain in the right upper quadrant. Abdominal ultrasound indicated acute cholecystitis and a single, extremely large pear-shaped gallstone (16.8 cm long, and 7.8 cm at its widest point and 4.1 cm at its narrowest point). Its fresh weight (at operation) was 278.0 g and, after 4 years, its dry weight was 259.5 g. Emergency classical cholecystectomy was carried out successfully. Discussion and Conclusion We have been unable to find a report of a larger gallstone in the English or Spanish language medical literature. PMID:22096735

  12. Oral plasmablastic lymphoma as the first manifestation of AIDS*

    PubMed Central

    do Vale, Daniela Assis; Rogado, Carolina Martelli; de Carvalho, Danielle Lima Corrêa; Trierveiler, Marilia; Ortega, Karem López

    2017-01-01

    Plasmablastic lymphoma is a non-Hodgkin lymphoma characterized by its plasmacytic differentiation and predilection for the oral cavity. It is among the lymphomas most commonly associated with AIDS. This report details a case of a HIV-positive patient with a 1-month history of an exophytic mass in the gingival area of the upper left quadrant. The diagnosis of plasmablastic lymphoma was made based on its histopathological and immunophenotypical features. She was treated with chemotherapy followed by autologous hematopoietic stem cell transplantation. Despite complete resolution of the lesion, the patient died of cardiorespiratory arrest. This case illustrates plasmablastic lymphoma as the first clinical manifestation of AIDS, highlighting the importance of differentiating between a potentially malignant lesion and other pathologic processes. PMID:29267464

  13. A rare case of perforated "sub-hepatic appendicitis" - a challenging differential diagnosis of acute abdomen based on the combination of appendicitis and maldescent of the caecum.

    PubMed

    Chiapponi, Costanza; Jannasch, Olof; Petersen, Manuela; Lessel, Wiebke; Bruns, Christiane; Meyer, Frank

    2017-01-01

    Unusual locations of the appendix vermiformis can result in delay in appropriate diagnosis and treatment of appendicitis. So an inflamed appendix in a sub-hepatic caecum caused by caecal maldescent for example can mimic cholecystitis, the pain being localized in the right upper quadrant. Here, we present a case of perforated sub-hepatic appendicitis with peritonitis, requiring open ileocaecal resection. Review of the existing literature has demonstrated that this pathology is uncommon, yet not so rare as one might presume. In conclusion, surgeons should be aware of this possibility in the diagnostic and therapeutic management of acute abdomen. Copyright © 2016. Published by Elsevier GmbH.

  14. The variable presentations and broadening geographic distribution of hepatic fascioliasis.

    PubMed

    Rowan, Sarah E; Levi, Marilyn E; Youngwerth, Jean M; Brauer, Brian; Everson, Gregory T; Johnson, Steven C

    2012-06-01

    We report 2 unrelated cases of hepatic fascioliasis in travelers returning to the United States from Africa and the Middle East. The first case presented with acute infection. Prominent clinical features included abdominal pain, elevated liver transaminases, serpiginous hepatic lesions, pericapsular hematoma, and marked peripheral eosinophilia. The second case was diagnosed in the chronic stage of infection and presented with right upper quadrant abdominal pain, cystic hepatic lesions, and an adult fluke in the common bile duct. We review the life cycle of Fasciola species, the corresponding clinical features during the stages of human infection, diagnostic methods, and the evolving understanding of the epidemiology of human fascioliasis, particularly emphasizing fascioliasis in African countries. Copyright © 2012 AGA Institute. Published by Elsevier Inc. All rights reserved.

  15. Flood Syndrome: Spontaneous Umbilical Hernia Rupture Leaking Ascitic Fluid—A Case Report

    PubMed Central

    Nguyen, Emilie T; Tudtud-Hans, Leah A

    2017-01-01

    Introduction We report a rare case of Flood syndrome, which is a spontaneous rupture of an umbilical hernia. Case Presentation A 42-year-old man with decompensated hepatitis C and alcoholic cirrhosis complicated by ascites and esophageal varices presented with 1 day of ascitic fluid drainage after rupture of a preexisting umbilical hernia associated with diffuse abdominal pain and tenderness. A pigtail drain was placed in the right upper abdominal quadrant to decrease fluid drainage from the abdominal wall defect, allowing it to heal naturally. Discussion The spontaneous rupture of an umbilical hernia in our patient highlights a rare complication with high mortality rates and stresses the challenge of treatment that falls in the area between medical and surgical management. PMID:28678688

  16. Flood Syndrome: Spontaneous Umbilical Hernia Rupture Leaking Ascitic Fluid-A Case Report.

    PubMed

    Nguyen, Emilie T; Tudtud-Hans, Leah A

    2017-01-01

    We report a rare case of Flood syndrome, which is a spontaneous rupture of an umbilical hernia. A 42-year-old man with decompensated hepatitis C and alcoholic cirrhosis complicated by ascites and esophageal varices presented with 1 day of ascitic fluid drainage after rupture of a preexisting umbilical hernia associated with diffuse abdominal pain and tenderness. A pigtail drain was placed in the right upper abdominal quadrant to decrease fluid drainage from the abdominal wall defect, allowing it to heal naturally. The spontaneous rupture of an umbilical hernia in our patient highlights a rare complication with high mortality rates and stresses the challenge of treatment that falls in the area between medical and surgical management.

  17. CHOROIDAL THICKNESS IN HEALTHY CHINESE CHILDREN AGED 6 to 12: The Shanghai Children Eye Study.

    PubMed

    He, Xiangui; Jin, Peiyao; Zou, Haidong; Li, Qiangqiang; Jin, Jiali; Lu, Lina; Zhao, Huijuan; He, Jiangnan; Xu, Xun; Wang, Mingjin; Zhu, Jianfeng

    2017-02-01

    To explore the characteristics of choroidal thickness (ChT) in Chinese children. A total of 144 healthy children, aged 6 years to 12 years old, were enrolled in the study. The ChT of subfovea and peripheral locations 0.5, 1.5, and 2.5 mm away from the fovea were evaluated by enhanced depth imaging optical coherence tomography. The association between subfoveal ChT and systemic, as well as ocular factors, including age, sex, height, weight, body mass index, axial length, refractive error, intraocular pressure, preterm history, and the refractive status of parents were studied. The mean subfoveal ChT was 302 ± 63 μm. In the nasal, superior, and inferior areas, the ChT of locations closer to the fovea was thicker than those farther away from the fovea (all P < 0.05); however, ChT was not significantly different among different locations in the temporal area (P = 0.16). The ChT of the nasal quadrant was significantly thinner than that of other areas (P < 0.01). Subfoveal ChT decreased with age, axial length, preterm history, and increased with height. Sex was not statistically associated with subfoveal ChT. In Chinese children, the ChT is thinnest in the nasal quadrant and thicker in central regions than in peripheral areas. The subfoveal ChT independently decreases with age, axial length, preterm history, and increases with height.

  18. Solid State Research

    DTIC Science & Technology

    1975-04-17

    1-3. CO2 laser raster scan sensitivity profile of HgCdTe quadrantal array with two of the four elements connected to 50-ohm load. Fig. 1-4...Response of HgCdTe quadrantal array to CO2 laser beam scanned across center with (a) two opposite photodiodes connected, and (b) all four photodiodes...RESEARCH 1 A. Planar HgCdTe Quadrantal Arrays for Gigahertz Heterodyne Operation at 10.6 (im 1 B. Electrical Properties of Silicon Ion-Implanted

  19. Research on correction algorithm of laser positioning system based on four quadrant detector

    NASA Astrophysics Data System (ADS)

    Gao, Qingsong; Meng, Xiangyong; Qian, Weixian; Cai, Guixia

    2018-02-01

    This paper first introduces the basic principle of the four quadrant detector, and a set of laser positioning experiment system is built based on the four quadrant detector. Four quadrant laser positioning system in the actual application, not only exist interference of background light and detector dark current noise, and the influence of random noise, system stability, spot equivalent error can't be ignored, so it is very important to system calibration and correction. This paper analyzes the various factors of system positioning error, and then propose an algorithm for correcting the system error, the results of simulation and experiment show that the modified algorithm can improve the effect of system error on positioning and improve the positioning accuracy.

  20. Temporal arteritis

    MedlinePlus

    ... the blood vessels that supply blood to the head, neck, upper body and arms. It is also called ... the blood vessels that supply blood to the head, neck, upper body, and arms. It most commonly occurs ...

  1. Earth observations taken during STS-98 mission

    NASA Image and Video Library

    2001-02-07

    STS098-714A-020 (7-20 February 2001) ---One of the STS-98 astronauts aboard the Earth-orbiting Space Shuttle Atlantis used a 70mm handheld camera to record this image of Southern California. Snow blanketing the higher elevations in the Los Padres National Forest (center of the image) and that covering the Angeles National Forest (right middle) help to accentuate and separate three major landform regions in southern California. The northern Los Angeles Basin that includes the San Fernando Valley and the Santa Monica Mountains is visible in the lower right quadrant of the image. The western end of the Mojave Desert (upper right) shows the two distinctive mountain boundaries along the southwest and northwest edge of the desert. The San Andreas Fault and the Garlock Fault converge (snow covered in this scene) at the western end of the desert. The intensively irrigated and cultivated southern end of the San Joaquin Valley that includes Bakersfield is visible (upper left) north of the snow-covered, northeast-southwest trending Tehachapi Mountains. The island off of the California coast (bottom left) is Santa Cruz Island.

  2. Multiple splenic abscesses in a rather healthy woman: a case report.

    PubMed

    Saber, Aly

    2009-07-23

    Abscess of the spleen is a rather clinical rarity with reported mortality rate up to 47%. The timely and widespread use of imaging methods facilitates early diagnosis and guides treatment, thus improving the prognosis. Most of patients were with recognized risk factors including conditions that compromise the immune system, trauma and intravenous drug abuse in addicts. The surgical treatment by splenectomy is usually the first choice of treatment. A healthy 45-year-old woman presented to the outpatient clinic with fever, 39 degrees C together with persistent upper-left-quadrant abdominal pain. Her past medical history was free from any chronic debilitating diseases or other predisposing factors. Imaging included chest and abdominal X-ray, followed by a CT scan of the upper abdomen. Splenic abscess is an unusual and potentially life-threatening disease with a diagnostic challenge due to the nonspecific clinical picture and diagnosis confirmed based mostly on imaging studies. Multiple splenic abscesses are very rarely encountered in surgical practice with a reported high mortality rate in neglected and untreated cases. Splenectomy is a safe procedure for patients with splenic abscess.

  3. Upper quadrant postural changes of school children in response to interaction with different information technologies.

    PubMed

    Briggs, Andrew; Straker, Leon; Greig, Alison

    2004-06-10

    The objective of this study was to quantitatively analyse the sitting posture of school children interacting with both old (book) and new (laptop and desktop computers) information technologies to test the hypothesis that posture is effected by the type of information technology (IT) used. A mixed model design was used to test the effect of IT type (within subjects) and age and gender (between subjects). The sitting posture of 32 children aged 4-17 years was measured whilst they read from a book, laptop, and desktop computer at a standard school chair and desk. Video images were captured and then digitized to calculate mean angles for head tilt, neck flexion, trunk flexion, and gaze angle. Posture was found to be influenced by IT type (p < 0.001), age (p < 0.001) and gender (p = 0.024) and significantly correlated to the stature of the participants. Measurement of resting posture and the maximal range of motion of the upper and lower cervical spines in the sagittal plane was also undertaken. The biophysical impact and the suitability of the three different information technologies are discussed.

  4. Learning to exploit a hidden predictor in skill acquisition: Tight linkage to conscious awareness.

    PubMed

    Tran, Randy; Pashler, Harold

    2017-01-01

    It is often assumed that implicit learning of skills based on predictive relationships proceeds independently of awareness. To test this idea, four groups of subjects played a game in which a fast-moving "demon" made a brief appearance at the bottom of the computer screen, then disappeared behind a V-shaped occluder, and finally re-appeared briefly on either the upper-left or upper-right quadrant of the screen. Points were scored by clicking on the demon during the final reappearance phase. Demons differed in several visible characteristics including color, horn height and eye size. For some subjects, horn height perfectly predicted which side the demon would reappear on. For subjects not told the rule, the subset who demonstrated at the end of the experiment that they had spontaneously discovered the rule showed strong evidence of exploiting it by anticipating the demon's arrival and laying in wait for it. Those who could not verbalize the rule performed no better than a control group for whom the demons moved unpredictably. The implications of this tight linkage between conscious awareness and implicit skill learning are discussed.

  5. A new color vision test to differentiate congenital and acquired color vision defects.

    PubMed

    Shin, Young Joo; Park, Kyu Hyung; Hwang, Jeong-Min; Wee, Won Ryang; Lee, Jin Hak

    2007-07-01

    To investigate the efficacy of a novel computer-controlled color test for the differentiation of congenital and acquired color vision deficiency. Observational cross-sectional study. Thirty-one patients with congenital color vision deficiency and 134 patients with acquired color vision deficiency with a Snellen visual acuity better than 20/30 underwent an ophthalmologic examination including the Ishihara color test, Hardy-Rand-Rittler test, Nagel anomaloscopy, and the Seohan computerized hue test between June, 2003, and January, 2004. To investigate the type of color vision defect, a graph of the Seohan computerized hue test was divided into 4 quadrants and error scores in each quadrant were summated. The ratio between the sums of error scores of quadrants I and III (Q1+Q3) and those of quadrants II and IV (Q2+Q4) was calculated. Error scores and ratio in quadrant analysis of the Seohan computerized hue test. The Seohan computerized hue test showed that the sum of Q2+Q4 was significantly higher than the sum of Q1+Q3 in congenital color vision deficiency (P<0.01, paired t test) and that the sum of Q2+Q4 was significantly lower than the sum of Q1+Q3 in acquired color vision deficiency (P<0.01, paired t test). In terms of discriminating congenital and acquired color vision deficiency, the ratio in quadrant analysis had 93.3% sensitivity and 98.5% specificity with a reference value of 1.5 by the Seohan computerized hue test (95% confidence interval). The quadrant analysis and ratio of (Q2+Q4)/(Q1+Q3) using the Seohan computerized hue test effectively differentiated congenital and acquired color vision deficiency.

  6. Gonioscopy in adult Chinese: the Liwan Eye Study.

    PubMed

    He, Mingguang; Foster, Paul J; Ge, Jian; Huang, Wenyong; Wang, Dandan; Friedman, David S; Khaw, Peng T

    2006-11-01

    To assess gonioscopic characteristics of the drainage angle in adult Chinese in an urban area of southern China. Clustered random sampling was used to select adults aged 50 years and older in Liwan District, Guangzhou. Gonioscopy was performed on all the subjects. The geometric angle width was graded in the superior and inferior quadrants, according to the Spaeth system. In addition, apparent and true iris insertion was classified in four quadrants with static and dynamic gonioscopy. The peripheral iris profile was described as steep, regular, concave, and plateau. Data are presented for all phakic right eyes. Secondary or iatrogenic cases were excluded in the analysis of peripheral anterior synechiae (PAS). Among 1405 participants in the study, data from 1330 (95%) right eyes were available for analysis. Iridotrabecular angles (ITA) < or =20 degrees were present in 36.9% (95% CI: 34.3%-40.0%) of eyes superiorly and in 27.9% (95% CI: 25.5%-30.4%) inferiorly. Narrower ITAs were more common in the older people (sex-adjusted odds ratio [OR] = 1.1 per year of life; P < 0.001) and the women (age-adjusted OR = 2.5, P < 0.001). Apparent iris insertion of grade A or B (with pigmented trabecular meshwork not visible) by quadrant was observed in 27.2% superiorly, 12.0% nasally, 7.7% inferiorly, and 14.2% temporally. Narrow angles (in which pigmented trabecular meshwork was not visible in three or more quadrants) were identified in 11.0% (95% CI: 9.3%-12.7%) of right eyes. Overall, 33.3% of eyes had a steep iris profile, 54.2% were normal, 2.7% were concave, and 10.1% were graded plateau. PAS were seen in 30 of 146 (20.5%) eyes with narrow angles and in 7 (0.6%) of 1184 eyes with angles that did not meet criteria for narrow angles. PAS were more likely with narrower angles, with 0%, 0.3%, and 1.9% of eyes with a mean ITA of 40 degrees, 30 degrees, and 20 degrees, respectively, having PAS as opposed to 12.6% and 27.5% for those with ITA 10 degrees and 0 degrees , respectively. Ten percent of this population of southern Chinese persons 50 years of age and older had narrow angles. PAS were present in one fifth of these people. From these cross-sectional data, it is unclear which of these individuals are at highest risk of the development of primary angle-closure (PAC) glaucoma. Longitudinal studies are necessary to determine appropriate strategies for preventing this potentially blinding outcome.

  7. The IRAS Minor Planet Survey

    DTIC Science & Technology

    1992-12-01

    ecliptic longitude changed from -2100 to -2600 over the course of the IRAS mission. Thus, in these plots it would be located in the lower left quadrant ...degrees ecliptic longitude is towards the top of this plot. During the 1983 IRAS mission, Jupiter was in the lower left quadrant near an ecliptic...Most hot stars and cold background sources are outside the range of this color window (cf., lower right quadrant of Fig. 15). The 12 pm to 25 prm

  8. Vertical structure of aeolian turbulence in a boundary layer with sand transport

    NASA Astrophysics Data System (ADS)

    Lee, Zoe S.; Baas, Andreas C. W.

    2016-04-01

    Recently we have found that Reynolds shear stress shows a significant variability with measurement height (Lee and Baas, 2016), and so an alternative parameter for boundary layer turbulence may help to explain the relationship between wind forcing and sediment transport. We present data that were collected during a field study of boundary layer turbulence conducted on a North Atlantic beach. High-frequency (50 Hz) 3D wind velocity measurements were collected using ultrasonic anemometry at thirteen different measurement heights in a tight vertical array between 0.11 and 1.62 metres above the surface. Thanks to the high density installation of sensors a detailed analysis of the boundary layer flow can be conducted using methods more typically used in studies where data is only available from one or just a few measurement heights. We use quadrant analysis to explore the vertical structure of turbulence and track the changes in quadrant signatures with measurement elevation and over time. Results of quadrant analysis, at the 'raw' 50 Hz timescale, demonstrates the tendency for event clustering across all four quadrants, which implies that at-a-point quadrant events are part of larger-scale turbulent structures. Using an HSV colour model, applied to the quadrant analysis data and plotted in series, we create colour maps of turbulence, which can provide a clear visualisation of the clustering of event activity at each height and illustrate the shape of the larger coherent flow structures that are present within the boundary layer. By including a saturation component to the colour model, the most significant stress producing sections of the data are emphasised. This results in a 'banded' colour map, which relates to clustering of quadrant I (Outward Interaction) and quadrant IV (Sweep) activity, separate from clustering of quadrant II (Burst) and quadrant III (Inward Interaction). Both 'sweep-type' and 'burst-type' sequences are shown to have a diagonal structure originating from the top of the boundary layer, indicating a downwards direction of eddy motion. While directionality of turbulence cannot be definitively determined, our results indicate that the top-down turbulence model is a suitable explanation, further supported by the presence of 'incomplete' eddies which originate at higher elevations but fail to extend to the surface. This provides the first evidence in support of a top down turbulence model as observed in aeolian geomorphology, and we present preliminary findings on its relationship to sand transport activity. Lee, Z.S., Baas, A.C.W. (2016) Variable and conflicting shear stress estimates inside a boundary layer with sediment transport. Earth Surface Processes and Landforms; DOI: 10.1002/esp.3829

  9. Variability of Upper-Tropospheric Precipitable from Satellite and Model Reanalysis Datasets

    NASA Technical Reports Server (NTRS)

    Jedlovec, Gary J.; Iwai, Hisaki

    1999-01-01

    Numerous datasets have been used to quantify water vapor and its variability in the upper-troposphere from satellite and model reanalysis data. These investigations have shown some usefulness in monitoring seasonal and inter-annual variations in moisture either globally, with polar orbiting satellite data or global model output analysis, or regionally, with the higher spatial and temporal resolution geostationary measurements. The datasets are not without limitations, however, due to coverage or limited temporal sampling, and may also contain bias in their representation of moisture processes. The research presented in this conference paper inter-compares the NVAP, NCEP/NCAR and DAO reanalysis models, and GOES satellite measurements of upper-tropospheric,precipitable water for the period from 1988-1994. This period captures several dramatic swings in climate events associated with ENSO events. The data are evaluated for temporal and spatial continuity, inter-compared to assess reliability and potential bias, and analyzed in light of expected trends due to changes in precipitation and synoptic-scale weather features. This work is the follow-on to previous research which evaluated total precipitable water over the same period. The relationship between total and upper-level precipitable water in the datasets will be discussed as well.

  10. Novel 16-channel receive coil array for accelerated upper airway MRI at 3 Tesla.

    PubMed

    Kim, Yoon-Chul; Hayes, Cecil E; Narayanan, Shrikanth S; Nayak, Krishna S

    2011-06-01

    Upper airway MRI can provide a noninvasive assessment of speech and swallowing disorders and sleep apnea. Recent work has demonstrated the value of high-resolution three-dimensional imaging and dynamic two-dimensional imaging and the importance of further improvements in spatio-temporal resolution. The purpose of the study was to describe a novel 16-channel 3 Tesla receive coil that is highly sensitive to the human upper airway and investigate the performance of accelerated upper airway MRI with the coil. In three-dimensional imaging of the upper airway during static posture, 6-fold acceleration is demonstrated using parallel imaging, potentially leading to capturing a whole three-dimensional vocal tract with 1.25 mm isotropic resolution within 9 sec of sustained sound production. Midsagittal spiral parallel imaging of vocal tract dynamics during natural speech production is demonstrated with 2 × 2 mm(2) in-plane spatial and 84 ms temporal resolution. Copyright © 2010 Wiley-Liss, Inc.

  11. Multi-quadrant biopsy technique improves diagnostic ability in large heterogeneous renal masses. Abel EJ, Heckman JE, Hinshaw L, Best S, Lubner M, Jarrard DF, Downs TM, Nakada SY, Lee FT Jr, Huang W, Ziemlewicz T.J Urol. 2015 Oct;194(4):886-91. [Epub 2015 Mar 30]. doi: 10.1016/j.juro.2015.03.106.

    PubMed

    Jay, Raman; Heckman, J E; Hinshaw, L; Best, S; Lubner, M; Jarrard, D F; Downs, T M; Nakada, S Y; Lee, F T; Huang, W; Ziemlewicz, T

    2017-03-01

    Percutaneous biopsy obtained from a single location is prone to sampling error in large heterogeneous renal masses, leading to nondiagnostic results or failure to detect poor prognostic features. We evaluated the accuracy of percutaneous biopsy for large renal masses using a modified multi-quadrant technique vs. a standard biopsy technique. Clinical and pathological data for all patients with cT2 or greater renal masses who underwent percutaneous biopsy from 2009 to 2014 were reviewed. The multi-quadrant technique was defined as multiple core biopsies from at least 4 separate solid enhancing areas in the tumor. The incidence of nondiagnostic findings, sarcomatoid features and procedural complications was recorded, and concordance between biopsy specimens and nephrectomy pathology was compared. A total of 122 biopsies were performed for 117 tumors in 116 patients (46 using the standard biopsy technique and 76 using the multi-quadrant technique). Median tumor size was 10cm (IQR: 8-12). Biopsy was nondiagnostic in 5 of 46 (10.9%) standard and 0 of 76 (0%) multi-quadrant biopsies (P = 0.007). Renal cell carcinoma was identified in 96 of 115 (82.0%) tumors and nonrenal cell carcinoma tumors were identified in 21 (18.0%). One complication occurred using the standard biopsy technique and no complications were reported using the multi-quadrant technique. Sarcomatoid features were present in 23 of 96 (23.9%) large renal cell carcinomas studied. Sensitivity for identifying sarcomatoid features was higher using the multi-quadrant technique compared to the standard biopsy technique at 13 of 15 (86.7%) vs. 2 of 8 (25.0%) (P = 0.0062). The multi-quadrant percutaneous biopsy technique increases the ability to identify aggressive pathological features in large renal tumors and decreases nondiagnostic biopsy rates. Copyright © 2017. Published by Elsevier Inc.

  12. The medial temporal lobe-conduit of parallel connectivity: a model for attention, memory, and perception.

    PubMed

    Mozaffari, Brian

    2014-01-01

    Based on the notion that the brain is equipped with a hierarchical organization, which embodies environmental contingencies across many time scales, this paper suggests that the medial temporal lobe (MTL)-located deep in the hierarchy-serves as a bridge connecting supra- to infra-MTL levels. Bridging the upper and lower regions of the hierarchy provides a parallel architecture that optimizes information flow between upper and lower regions to aid attention, encoding, and processing of quick complex visual phenomenon. Bypassing intermediate hierarchy levels, information conveyed through the MTL "bridge" allows upper levels to make educated predictions about the prevailing context and accordingly select lower representations to increase the efficiency of predictive coding throughout the hierarchy. This selection or activation/deactivation is associated with endogenous attention. In the event that these "bridge" predictions are inaccurate, this architecture enables the rapid encoding of novel contingencies. A review of hierarchical models in relation to memory is provided along with a new theory, Medial-temporal-lobe Conduit for Parallel Connectivity (MCPC). In this scheme, consolidation is considered as a secondary process, occurring after a MTL-bridged connection, which eventually allows upper and lower levels to access each other directly. With repeated reactivations, as contingencies become consolidated, less MTL activity is predicted. Finally, MTL bridging may aid processing transient but structured perceptual events, by allowing communication between upper and lower levels without calling on intermediate levels of representation.

  13. Seedling establishment and physiological responses to temporal and spatial soil moisture changes

    Treesearch

    Jeremy Pinto; John D. Marshall; Kas Dumroese; Anthony S. Davis; Douglas R. Cobos

    2016-01-01

    In many forests of the world, the summer season (temporal element) brings drought conditions causing low soil moisture in the upper soil profile (spatial element) - a potentially large barrier to seedling establishment. We evaluated the relationship between initial seedling root depth, temporal and spatial changes in soil moisture during drought after...

  14. [Diffuse retinal epitheliopathy].

    PubMed

    Abaloun, Yassine; Omari, Abdelhadi

    2017-01-01

    We report the case of a 52-year old man with no previous significant medical history presenting with progressive decrease in visual acuity (VA) of the right eye evolving over 10 years. Corrected visual acuity was 2/10 - P6 in the RE and 10/10 - P2 in the LE. The examination of the anterior segment was unremarkable. Fundus examination showed alteration of the pigment epithelium (APE) in the RE associated with osteoblast-like pigment migrations involving the macula and a wide area due to gravitational descent of the superior temporal arcade onto the lower temporal quadrant. The left eye had a similar appearance especially in the inter-papillo-macular region (A,B). Fluorescein angiography showed early hyperfluorescence areas in the PE depigmented areas associated with pigment migrations giving a comet tail appearance by gravity casting in both eyes (C,D). Optical coherence tomography (OCT) showed retrofoveolar epithelial detachment (PED) at the level of the RE (E). The patient received Diamox therapy with regular monitoring to manage possible leakage points. Patient 's evolution was marked by PED regression and VA improvement.

  15. Finite element modeling of sound transmission with perforations of tympanic membrane

    PubMed Central

    Gan, Rong Z.; Cheng, Tao; Dai, Chenkai; Yang, Fan; Wood, Mark W.

    2009-01-01

    A three-dimensional finite element (FE) model of human ear with structures of the external ear canal, middle ear, and cochlea has been developed recently. In this paper, the FE model was used to predict the effect of tympanic membrane (TM) perforations on sound transmission through the middle ear. Two perforations were made in the posterior-inferior quadrant and inferior site of the TM in the model with areas of 1.33 and 0.82 mm2, respectively. These perforations were also created in human temporal bones with the same size and location. The vibrations of the TM (umbo) and stapes footplate were calculated from the model and measured from the temporal bones using laser Doppler vibrometers. The sound pressure in the middle ear cavity was derived from the model and measured from the bones. The results demonstrate that the TM perforations can be simulated in the FE model with geometrical visualization. The FE model provides reasonable predictions on effects of perforation size and location on middle ear transfer function. The middle ear structure-function relationship can be revealed with multi-field coupled FE analysis. PMID:19603881

  16. Relation of sound intensity and accuracy of localization.

    PubMed

    Farrimond, T

    1989-08-01

    Tests were carried out on 17 subjects to determine the accuracy of monaural sound localization when the head is not free to turn toward the sound source. Maximum accuracy of localization for a constant-volume sound source coincided with the position for maximum perceived intensity of the sound in the front quadrant. There was a tendency for sounds to be perceived more often as coming from a position directly toward the ear. That is, for sounds in the front quadrant, errors of localization tended to be predominantly clockwise (i.e., biased toward a line directly facing the ear). Errors for sounds occurring in the rear quadrant tended to be anticlockwise. The pinna's differential effect on sound intensity between front and rear quadrants would assist in identifying the direction of movement of objects, for example an insect, passing the ear.

  17. Interpersonal Subtypes and Therapy Response in Patients Treated for Posttraumatic Stress Disorder.

    PubMed

    König, Julia; Onnen, Margarete; Karl, Regina; Rosner, Rita; Butollo, Willi

    2016-01-01

    Interpersonal traits may influence psychotherapy success. One way of conceptualizing such traits is the interpersonal circumplex model. In this study, we analyse interpersonal circumplex data, assessed with the Inventory of Interpersonal Problems (Horowitz, Strauß, & Kordy, 1994) from a randomized study with 138 patients suffering from posttraumatic stress disorder after trauma in adulthood. The study compared cognitive processing therapy and dialogical exposure therapy, a Gestalt-based intervention. We divided the interpersonally heterogeneous sample according to the quadrants of the interpersonal circumplex. The division into quadrants yielded subgroups that did not differ in their general psychological distress, but the cold-submissive quadrant tended to exhibit higher posttraumatic stress disorder symptom severity and interpersonal distress than the other three. There was also a trend for patients in different quadrants to be affected differently by the treatments. Correlation analyses supported these results: in cognitive processing therapy, more dominant patients had more successful therapies, while in dialogical exposure therapy, success was not correlated with interpersonal style. Results indicate that especially patients with cold interpersonal styles profited differentially from the two treatments offered. Dividing samples according to the interpersonal circumplex quadrants seems promising. Interpersonal traits may contribute to psychotherapy outcome. Dividing the sample according to the quadrants of the interpersonal circumplex, as opposed to cluster analysis, yielded promising results. Patients higher in dominance fared better with cognitive processing therapy, while interpersonal style had no correlations with therapy success in dialogical exposure therapy. Copyright © 2015 John Wiley & Sons, Ltd.

  18. Longitudinal analysis on human cervical tissue using optical coherence tomography (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Gan, Yu; Yao, Wang; Myers, Kristin M.; Vink, Joy-Sarah Y.; Wapner, Ronald J.; Hendon, Christine P.

    2017-02-01

    Uterine cervical collagen fiber network is vital to the normal cervical function in pregnancy. Previously, we presented an orientation estimation method to enable dispersion analysis on a single axial slice of human cervical tissue obtained from the upper half of cervix using optical coherence tomography (OCT). How the collagen fiber network structure changes from the internal os (top of the cervix which meets the uterus) to external os (bottom of cervix which extends into the vagina), remains unknown due to depth penetration limitations of OCT. To establish a collagen fiber directionality "map" of the entire cervix, we imaged serial axial slices of human NP (n=11) and PG (n=2) cervical tissue obtained from the internal to external os using Institutional Review Board approved protocols at Columbia University Medical Center. Each slice was divided into four quadrants. In each quadrant, we stitched multiple overlapped OCT volumes and analyzed the en face images that were parallel to the surface. A pixel-wise directionality map was generated. We analyzed fiber trend by measuring the mean angles and quantified dispersion by calculating the standard deviation of the fiber direction over a region of 400 μm × 400 μm. For the initial four samples, our analysis confirms a circumferential fiber pattern in the outer region of slices at all depths. We found that the standard deviation close to internal os showed no significance to the standard deviation close to external os (p>0.05), indicating comparable dispersion.

  19. Sensitivity of titanium brackets to the corrosive influence of fluoride-containing toothpaste and tea.

    PubMed

    Harzer, W; Schröter, A; Gedrange, T; Muschter, F

    2001-08-01

    Titanium brackets are used in orthodontic patients with an allergy to nickel and other specific substances. In recent studies, the corrosive properties of fluoride-containing toothpastes with different pH values were investigated. The present in vivo study tested how the surfaces of titanium brackets react to the corrosive influence of acidic fluoride-containing toothpaste during orthodontic treatment. Molar bands were placed on 18 orthodontic patients. In these same patients, titanium brackets were bonded on the left quadrants and stainless steel brackets on the right quadrants of the upper and lower arches. Fifteen patients used Gel Kam containing soluble tin fluoride (pH 3.2), whereas 3 used fluoride-free toothpaste. The brackets were removed for evaluation by light microscopy and scanning microscopy 5.5 to 7.0 months and 7.5 to 17 months after bonding. The quality and quantity of elements present were measured by scanning microscopy. Macroscopic evaluation showed the matte gray color of titanium brackets dominating over the silver gleam of the steel brackets. The plaque accumulation on titanium brackets is high because of the very rough surface. Pitting and crevices were observed in only 3 of the 165 brackets tested. The present in vivo investigation confirms the results of in vitro studies, but the changes are so minor that titanium brackets can safely be used for up to 18 months. Wing surfaces should be improved by modifying the manufacturing process.

  20. Type V hypertriglyceridemia in children, a therapeutic challenge in pediatrics: A case report and a review of the literature.

    PubMed

    Mărginean, Cristina Oana; Meliţ, Lorena Elena; Dobreanu, Minodora; Mărginean, Maria Oana

    2017-12-01

    Hypertriglyceridemia is defined as a level of triglycerides above 150 mg/dL. The complex causes and classification of hypertriglyceridemia lead to difficulties in the diagnosis and management of this condition. We present the case of a 15 years and 6 months old female teenager, admitted in our clinic for the following complaints: severe abdominal pain predominantly in the lateral left quadrant, nausea, vomiting, and the lack of stools for 2 days. The clinical exam showed: impaired general status, painful abdomen at superficial and deep palpation in the left and upper abdominal quadrants, the absence of stools for 2 days. The laboratory parameters revealed leukocytosis with neutrophilia, thrombocytopenia, high level of serum amylase and triglycerides, and increased inflammatory biomarkers. The imagistic investigations showed ascites and paralytic ileus. The management was burdened by the side-effects of hypolipidemic drugs impairing the liver function and leading to rhabdomyolysis, but eventually the patient's outcome was good. Type V hyperlipoproteinemia is a rare condition accounting for approximately 5% of the cases. The risk for acute pancreatitis is well-known to be associated with hypertriglyceridemia, even though in rare cases. The prognosis of hypertriglyceridemia is pediatrics is burdened not only by the long-term risk factors associated to the diseases itself, but also by the negative effects of long-term hypolipidemic treatment. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

  1. A simple football injury leading to a grade 4 renal trauma.

    PubMed

    Fanning, Deirdre Mary; Forde, James C; Mohan, Ponnusamy

    2012-03-08

    This case highlights the need for cautious management and serial regular examination of trauma patients. A 22-year-old Caucasian male presented to the emergency department 4 h following an injury sustained during football training. He complained of the immediate onset of severe left upper quadrant and left flank pain. He subsequently developed frank haematuria. On initial review, he was haemodynamically stable. CT of the abdomen and pelvis showed a grade 4 renal trauma. Over the following 36 h, he remained haemodynamically stable. On serial abdominal examinations however, he developed a rigid abdomen and was noted to have a haemoglobin drop. Interval CT scan showed a progression of his injury and the presence of a haemoperitoneum. An emergency laparotomy was performed resulting in a left nephrectomy. He made an uneventful recovery.

  2. Nodular Fasciitis of the Breast Previously Misdiagnosed as Breast Carcinoma

    PubMed Central

    Ozben, Volkan; Aydogan, Fatih; Karaca, Fatih Can; Ilvan, Sennur; Uras, Cihan

    2009-01-01

    Summary Background Nodular fasciitis of the breast is a rare benign pathology that can mimic breast cancer clinically, radiologically, and histopathologically. Case Report An 18-year-old female patient had first visited a physician in a different center with the complaint of a lump in her left breast. Breast examination had revealed a palpable mass located in the left upper outer quadrant. Ultrasonography had demonstrated a hypoechoic lesion. Excisional biopsy of the lump had been performed and histopathologic examination misdiagnosed this lump as a mesenchymal tumor. The patient was then referred to our clinic for further investigations. Pathologic revision was performed and the diagnosis of nodular fasciitis of the breast was established. Conclusion Awareness of this rare clinical entity, nodular fasciitis, in the breast eliminates the misdiagnosis of breast cancer. PMID:20877676

  3. [A rare differential diagnosis of a somatoform autonomous disorder of the gastro-intestinal tract: the hepatocellular liver carcinoma in childhood].

    PubMed

    Voll, Renate

    2008-07-01

    A severely ill 11-year-old boy came to the child psychiatric outpatient department of the Fachkrankenhaus Neckargemünd with the diagnosis of a somatoform disorder. Main symptoms included nausea, vomiting, abdominal pain and diarrhoea. He wished to be examined in order to enter the Stephen-Hawking-School for physically handicapped children in the town of Neckargemünd. Manual examination revealed a palpable mass in the right upper quadrant of the abdomen, which was imaged as a tumour of the liver. During the subsequent operation, a 500 ml hepatocellular carcinoma was found. The symptoms of the hepatocellular carcinoma, which rarely occurs in childhood, can perfectly mimic those of a somatoform disorder of the gastro-intestinal tract.

  4. Primary hydatid disease of diaphragm with subcutenous extension.

    PubMed

    Gümüş, Metehan; Yağmur, Yusuf; Gümüş, Hatice; Kapan, Murat; Onder, Akın; Böyük, Abdullah

    2011-08-12

    While diaphragmatic hydatid disease is a rare condition, subcutaneous extension of the disease is very rare. A 33-year-old female visited our clinic due to swelling on the right upper quadrant of the abdomen. Thoraco-abdominal CT scan and MRI revealed a hydatid cyst (110 x 98 x 78 mm) located in the costal part of the hemidiaphragm extending into the preperitoneal space and protruding intercostally to a subcutaneous area. Total pericyst resection without opening the cyst, including a margin of normal diaphragm, was performed. The patient was started on albendazole for three months. Hydatid cyst in the diaphragm should be considered in patients with preoperative imaging data indicating cystic lesions adjacent to the diaphragm, especially for cystic lesions encountered in patients who live in or who have come from endemic regions.

  5. A Highly Linear and Wide Input Range Four-Quadrant CMOS Analog Multiplier Using Active Feedback

    NASA Astrophysics Data System (ADS)

    Huang, Zhangcai; Jiang, Minglu; Inoue, Yasuaki

    Analog multipliers are one of the most important building blocks in analog signal processing circuits. The performance with high linearity and wide input range is usually required for analog four-quadrant multipliers in most applications. Therefore, a highly linear and wide input range four-quadrant CMOS analog multiplier using active feedback is proposed in this paper. Firstly, a novel configuration of four-quadrant multiplier cell is presented. Its input dynamic range and linearity are improved significantly by adding two resistors compared with the conventional structure. Then based on the proposed multiplier cell configuration, a four-quadrant CMOS analog multiplier with active feedback technique is implemented by two operational amplifiers. Because of both the proposed multiplier cell and active feedback technique, the proposed multiplier achieves a much wider input range with higher linearity than conventional structures. The proposed multiplier was fabricated by a 0.6µm CMOS process. Experimental results show that the input range of the proposed multiplier can be up to 5.6Vpp with 0.159% linearity error on VX and 4.8Vpp with 0.51% linearity error on VY for ±2.5V power supply voltages, respectively.

  6. Immediate effects of plantar inputs on the upper half muscles and upright posture: a preliminary study.

    PubMed

    Ciuffolo, Fabio; Ferritto, Anna L; Muratore, Filippo; Tecco, Simona; Testa, Mauro; D'Attilio, Michele; Festa, Felice

    2006-01-01

    This purpose of this study was to investigate the immediate effects of plantar inputs on both the upper half muscle activity (anterior temporal, masseter, digastric, sternocleidomastoid, upper and lower trapezius, cervical) and the body posture, by means of electromyography (EMG) and vertical force platform, respectively. Twenty four (24) healthy adults, between the ages of 24 and 31 years (25.3 +/- 1.9), with no history of craniomandibular disorder or systemic musculoskeletal dysfunction, were randomly divided into two groups: test group (fourteen subjects) and control group (ten subjects). A first recording session (TO) measured the baseline EMG and postural patterns of both groups. After this session, the test group wore test shoes with insoles that stimulated the plantar surfaces, while the control group wore placebo shoes. After one hour, a second set of measurements (T1) were performed. Significant differences between the groups at baseline were observed in the left anterior temporal, left cervical, and left upper trapezius, as well as at T1 in the left anterior temporal and right upper trapezius (p < 0.05). Within-test group analysis showed a significant increase of the right upper trapezius activity (p < 0.05), whereas no changes were found by within-control group analysis. Lower risk of asymmetric muscle patterns and postural blindness in the test group compared to the control group was observed. Further studies are warranted to investigate the short and long-term effects of this type of insole, in patients with both craniomandibular-cervical and lower extremity disorders.

  7. Evaluating the Patient with Left Lower Quadrant Abdominal Pain.

    PubMed

    Bodmer, Nicholas A; Thakrar, Kiran H

    2015-11-01

    Left lower quadrant pain is a frequent indication for imaging in the emergency department. Most causes of pain originate from the colon, including diverticulitis, colitis, fecal impaction, and epiploic appendagitis. Left-sided urolithiasis and spontaneous hemorrhage in the retroperitoneum or rectus sheath are additional causes of pain. Computed tomography is the preferred imaging modality in the emergent setting for all of these pathologic conditions. Gynecologic, testicular, and neoplastic pathology may also cause left lower quadrant pain but are not discussed in this article. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Upper Oceanic Energy Response to Tropical Cyclone Passage

    DTIC Science & Technology

    2013-04-15

    insolation, and the upper ocean stratification . The importance of the upper ocean energy content to TCs, particularly their intensification, has been...similar to those of Shay and Brewster (2010), who showed that the stable stratification of the east Pacific also makes the 100-m mixed layer depth a poor... The upper oceanic temporal response to tropical cyclone (TC) passage is investigated using a 6-yr daily record of data-driven analyses of two

  9. Antiallergic effect of the atomized extract of rhizome of Curcuma longa, flowers of Cordia lutea and leaves of Annona muricata

    PubMed Central

    Arroyo-Acevedo, Jorge; Franco-Quino, Cesar; Ruiz-Ramirez, Eliberto; Chávez-Asmat, Roberto; Anampa-Guzmán, Andrea; Raéz-González, Ernesto; Cabanillas-Coral, José

    2016-01-01

    Introduction Allergies are a problem that greatly affects the population, and hence the use of antiallergic medications is fairly widespread. However, these drugs have many adverse effects. The use of medicinal plants could be an option, but they need to be evaluated. Objective This study was designed to evaluate the antiallergic effect of the atomized extract of rhizome of Curcuma longa, flowers of Cordia lutea, and leaves of Annona muricata. Materials and methods Twenty-four New Zealand white albino rabbits were randomized into 2 groups. Group A received the atomized extract diluted in physiological saline (APS) and group B received it diluted in Freund’s adjuvant (FA). Then, the back of each rabbit was divided into 4 quadrants. The A-I quadrant received only physiological saline. The A-I quadrants of each rabbit conformed the PS group. The following 3 quadrants received the APS in 10 μg/mL, 100 μg/mL, and 1,000 μg/mL, respectively. The B-I quadrant received only FA. The B-I quadrants of each rabbit conformed the FA group. The following 3 quadrants received the AFA in 10 μg/mL, 100 μg/mL, and 1,000 μg/mL, respectively. The occurrence of erythema and edema was recorded according to the Draize scoring system and the primary irritation index. After 72 hours, biopsies were performed. Results The AFA group presented significantly less erythema and edema compared to the FA group (P<0.05). The histopathologic evaluation at 72 hours showed normal characteristics in the APS group. Conclusion Considering the clinical and histopathological signs, we conclude that the administration of the atomized extract of rhizome of C. longa, flowers of C. lutea, and leaves of A. muricata lacks antigenic effect but could have an antiallergenic effect in a model of dermal irritation in rabbits. PMID:27877047

  10. Antiallergic effect of the atomized extract of rhizome of Curcuma longa, flowers of Cordia lutea and leaves of Annona muricata.

    PubMed

    Arroyo-Acevedo, Jorge; Franco-Quino, Cesar; Ruiz-Ramirez, Eliberto; Chávez-Asmat, Roberto; Anampa-Guzmán, Andrea; Raéz-González, Ernesto; Cabanillas-Coral, José

    2016-01-01

    Allergies are a problem that greatly affects the population, and hence the use of antiallergic medications is fairly widespread. However, these drugs have many adverse effects. The use of medicinal plants could be an option, but they need to be evaluated. This study was designed to evaluate the antiallergic effect of the atomized extract of rhizome of Curcuma longa , flowers of Cordia lutea , and leaves of Annona muricata . Twenty-four New Zealand white albino rabbits were randomized into 2 groups. Group A received the atomized extract diluted in physiological saline (APS) and group B received it diluted in Freund's adjuvant (FA). Then, the back of each rabbit was divided into 4 quadrants. The A-I quadrant received only physiological saline. The A-I quadrants of each rabbit conformed the PS group. The following 3 quadrants received the APS in 10 μg/mL, 100 μg/mL, and 1,000 μg/mL, respectively. The B-I quadrant received only FA. The B-I quadrants of each rabbit conformed the FA group. The following 3 quadrants received the AFA in 10 μg/mL, 100 μg/mL, and 1,000 μg/mL, respectively. The occurrence of erythema and edema was recorded according to the Draize scoring system and the primary irritation index. After 72 hours, biopsies were performed. The AFA group presented significantly less erythema and edema compared to the FA group ( P <0.05). The histopathologic evaluation at 72 hours showed normal characteristics in the APS group. Considering the clinical and histopathological signs, we conclude that the administration of the atomized extract of rhizome of C. longa , flowers of C. lutea , and leaves of A. muricata lacks antigenic effect but could have an antiallergenic effect in a model of dermal irritation in rabbits.

  11. Anterior Segment Imaging Predicts Incident Gonioscopic Angle Closure.

    PubMed

    Baskaran, Mani; Iyer, Jayant V; Narayanaswamy, Arun K; He, Yingke; Sakata, Lisandro M; Wu, Renyi; Liu, Dianna; Nongpiur, Monisha E; Friedman, David S; Aung, Tin

    2015-12-01

    To investigate the incidence of gonioscopic angle closure after 4 years in subjects with gonioscopically open angles but varying degrees of angle closure detected on anterior segment optical coherence tomography (AS OCT; Visante; Carl Zeiss Meditec, Dublin, CA) at baseline. Prospective, observational study. Three hundred forty-two subjects, mostly Chinese, 50 years of age or older, were recruited, of whom 65 were controls with open angles on gonioscopy and AS OCT at baseline, and 277 were cases with baseline open angles on gonioscopy but closed angles (1-4 quadrants) on AS OCT scans. All subjects underwent gonioscopy and AS OCT at baseline (horizontal and vertical single scans) and after 4 years. The examiner performing gonioscopy was masked to the baseline and AS OCT data. Angle closure in a quadrant was defined as nonvisibility of the posterior trabecular meshwork by gonioscopy and visible iridotrabecular contact beyond the scleral spur in AS OCT scans. Gonioscopic angle closure in 2 or 3 quadrants after 4 years. There were no statistically significant differences in age, ethnicity, or gender between cases and controls. None of the control subjects demonstrated gonioscopic angle closure after 4 years. Forty-eight of the 277 subjects (17.3%; 95% confidence interval [CI], 12.8-23; P < 0.0001) with at least 1 quadrant of angle closure on AS OCT at baseline demonstrated gonioscopic angle closure in 2 or more quadrants, whereas 28 subjects (10.1%; 95% CI, 6.7-14.6; P < 0.004) demonstrated gonioscopic angle closure in 3 or more quadrants after 4 years. Individuals with more quadrants of angle closure on baseline AS OCT scans had a greater likelihood of gonioscopic angle closure developing after 4 years (P < 0.0001, chi-square test for trend for both definitions of angle closure). Anterior segment OCT imaging at baseline predicts incident gonioscopic angle closure after 4 years among subjects who have gonioscopically open angles and iridotrabecular contact on AS OCT at baseline. Copyright © 2015 American Academy of Ophthalmology. All rights reserved.

  12. 59. VIEW FROM THE NORTHEAST IN THE NORTHEAST QUADRANT. GENERAL ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    59. VIEW FROM THE NORTHEAST IN THE NORTHEAST QUADRANT. GENERAL VIEW OF THE RIGHT FLANK WALL. RIGHT SHOULDER ANGLE IS INCLUDED ON THE RIGHT SIDE OF THE PHOTOGRAPH. - Fort Sumter, Charleston, Charleston County, SC

  13. Illinois high-speed rail four-quadrant gate reliability assessment

    DOT National Transportation Integrated Search

    2009-10-01

    The Federal Railroad Administration (FRA) tasked the John A. Volpe National Transportation Systems Center (Volpe Center) to conduct a reliability analysis of the four-quadrant gate/vehicle detection equipment installed on the future high-speed rail (...

  14. 27 CFR 9.82 - Potter Valley.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... N.-T. 16 N. township line), the boundary runs northwest to the northeastern corner of quadrant 4, on the T. 18 N.-T. 17 N. township line; (2) Then west to the northwest corner of quadrant 1; (3) Then...

  15. 27 CFR 9.82 - Potter Valley.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... N.-T. 16 N. township line), the boundary runs northwest to the northeastern corner of quadrant 4, on the T. 18 N.-T. 17 N. township line; (2) Then west to the northwest corner of quadrant 1; (3) Then...

  16. A novel active disturbance rejection based tracking design for laser system with quadrant photodetector

    NASA Astrophysics Data System (ADS)

    Manojlović, Stojadin M.; Barbarić, Žarko P.; Mitrović, Srđan T.

    2015-06-01

    A new tracking design for laser systems with different arrangements of a quadrant photodetector, based on the principle of active disturbance rejection control is suggested. The detailed models of quadrant photodetector with standard add-subtract, difference-over-sum and diagonal-difference-over-sum algorithms for displacement signals are included in the control loop. Target moving, non-linearity of a photodetector, parameter perturbations and exterior disturbances are treated as a total disturbance. Active disturbance rejection controllers with linear extended state observers for total disturbance estimation and rejection are designed. Proposed methods are analysed in frequency domain to quantify their stability characteristics and disturbance rejection performances. It is shown through simulations, that tracking errors are effectively compensated, providing the laser spot positioning in the area near the centre of quadrant photodetector where the mentioned algorithms have the highest sensitivity, which provides tracking of the manoeuvring targets with high accuracy.

  17. Retinal architecture and mfERG: Optic nerve head component response characteristics in MS.

    PubMed

    Schnurman, Zane S; Frohman, Teresa C; Beh, Shin C; Conger, Darrel; Conger, Amy; Saidha, Shiv; Galetta, Steven; Calabresi, Peter A; Green, Ari J; Balcer, Laura J; Frohman, Elliot M

    2014-05-27

    To describe a novel neurophysiologic signature of the retinal ganglion cell and to elucidate its relationship to abnormalities in validated structural and functional measures of the visual system. We used multifocal electroretinogram-generated optic nerve head component (ONHC) responses from normal subjects (n = 18), patients with multiple sclerosis (MS) (n = 18), and those with glaucoma (n = 3). We then characterized the relationship between ONHC response abnormalities and performance on low-contrast visual acuity, multifocal visual-evoked potential-induced cortical responses, and average and quadrant retinal nerve fiber layer (RNFL) thicknesses, as measured by spectral-domain optical coherence tomography. Compared with the eyes of normal subjects, the eyes of patients with MS exhibited an increased number of abnormal or absent ONHC responses (p < 0.0001). For every 7-letter reduction in low-contrast letter acuity, there were corresponding 4.6 abnormal ONHC responses at 2.5% contrast (p < 0.0001) and 6.6 abnormalities at the 1.25% contrast level (p < 0.0001). Regarding average RNFL thickness, for each 10-μm thickness reduction, we correspondingly observed 6.8 abnormal ONHC responses (p = 0.0002). The most robust association was between RNFL thinning in the temporal quadrant and ONHC response abnormalities (p < 0.0001). Further characterization of ONHC abnormalities (those that are reversible and irreversible) may contribute to the development of novel neurotherapeutic strategies aimed at achieving neuroprotective, and perhaps even neurorestorative, effects in disorders that target the CNS in general, and MS in particular. © 2014 American Academy of Neurology.

  18. The SCHEIE Visual Field Grading System

    PubMed Central

    Sankar, Prithvi S.; O’Keefe, Laura; Choi, Daniel; Salowe, Rebecca; Miller-Ellis, Eydie; Lehman, Amanda; Addis, Victoria; Ramakrishnan, Meera; Natesh, Vikas; Whitehead, Gideon; Khachatryan, Naira; O’Brien, Joan

    2017-01-01

    Objective No method of grading visual field (VF) defects has been widely accepted throughout the glaucoma community. The SCHEIE (Systematic Classification of Humphrey visual fields-Easy Interpretation and Evaluation) grading system for glaucomatous visual fields was created to convey qualitative and quantitative information regarding visual field defects in an objective, reproducible, and easily applicable manner for research purposes. Methods The SCHEIE grading system is composed of a qualitative and quantitative score. The qualitative score consists of designation in one or more of the following categories: normal, central scotoma, paracentral scotoma, paracentral crescent, temporal quadrant, nasal quadrant, peripheral arcuate defect, expansive arcuate, or altitudinal defect. The quantitative component incorporates the Humphrey visual field index (VFI), location of visual defects for superior and inferior hemifields, and blind spot involvement. Accuracy and speed at grading using the qualitative and quantitative components was calculated for non-physician graders. Results Graders had a median accuracy of 96.67% for their qualitative scores and a median accuracy of 98.75% for their quantitative scores. Graders took a mean of 56 seconds per visual field to assign a qualitative score and 20 seconds per visual field to assign a quantitative score. Conclusion The SCHEIE grading system is a reproducible tool that combines qualitative and quantitative measurements to grade glaucomatous visual field defects. The system aims to standardize clinical staging and to make specific visual field defects more easily identifiable. Specific patterns of visual field loss may also be associated with genetic variants in future genetic analysis. PMID:28932621

  19. Spatial and Temporal Variability of Surface Energy Fluxes During Autumn Ice Advance: Observations and Model Validation

    NASA Astrophysics Data System (ADS)

    Persson, O. P. G.; Blomquist, B.; Grachev, A. A.; Guest, P. S.; Stammerjohn, S. E.; Solomon, A.; Cox, C. J.; Capotondi, A.; Fairall, C. W.; Intrieri, J. M.

    2016-12-01

    From Oct 4 to Nov 5, 2015, the Office of Naval Research - sponsored Sea State cruise in the Beaufort Sea with the new National Science Foundation R/V Sikuliaq obtained extensive in-situ and remote sensing observations of the lower troposphere, the advancing sea ice, wave state, and upper ocean conditions. In addition, a coupled atmosphere, sea ice, upper-ocean model, based on the RASM model, was run at NOAA/PSD in a hindcast mode for this same time period, providing a 10-day simulation of the atmosphere/ice/ocean evolution. Surface energy fluxes quantitatively represent the air-ice, air-ocean, and ice-ocean interaction processes, determining the cooling (warming) rate of the upper ocean and the growth (melting) rate of sea ice. These fluxes also impact the stratification of the lower troposphere and the upper ocean. In this presentation, both direct and indirect measurements of the energy fluxes during Sea State will be used to explore the spatial and temporal variability of these fluxes and the impacts of this variability on the upper ocean, ice, and lower atmosphere during the autumn ice advance. Analyses have suggested that these fluxes are impacted by atmospheric synoptic evolution, proximity to existing ice, ice-relative wind direction, ice thickness and snow depth. In turn, these fluxes impact upper-ocean heat loss and timing of ice formation, as well as stability in the lower troposphere and upper ocean, and hence heat transport to the free troposphere and ocean mixed-layer. Therefore, the atmospheric structure over the advancing first-year ice differs from that over the nearby open water. Finally, these observational analyses will be used to provide a preliminary validation of the spatial and temporal variability of the surface energy fluxes and the associated lower-tropospheric and upper-ocean structures in the simulations.

  20. A Coastal Bay Summer Breeze Study, Part 1: Results of the Quiberon 2006 Experimental Campaign

    NASA Astrophysics Data System (ADS)

    Mestayer, Patrice G.; Calmet, Isabelle; Herlédant, Olivier; Barré, Sophie; Piquet, Thibaud; Rosant, Jean-Michel

    2018-04-01

    The Quiberon 2006 experiment was launched to document the onset and development of land and sea breezes over a semi-circular coastal bay propitious to inshore sailing competitions. The measurements were taken during the 2 weeks of 16-28 June 2006. Micrometeorological variables were recorded at three shore sites around the bay using turbulence sensors on 10-30-m high masts, on four instrumented catamarans at selected sites within the bay, and at a fourth shore site with a Sodar. Synoptic data and local measurements are analyzed here from the point of view of both micrometeorologists and competition skippers, testing in particular the empirical rules of breeze veering and backing according to the wind direction with respect to the coastline orientation at the mesoscale (the quadrant theory). Our analysis focuses on the patterns of lower-altitude wind direction and speed around the bay and over the water basin, and the temporal variations during the periods of the breeze onset, establishment and thermal reinforcement. In offshore synoptic-flow conditions (quadrants 1 and 2), the clockwise rotation of the surface flow had a very large amplitude, reaching up to 360°. The breeze strength was negatively correlated to that of the synoptic wind speed. In conditions of onshore synoptic flow from the west (quadrant 3) at an angle to the mainland coast but perpendicular to the Quiberon peninsula, the rotation of the flow was backwards in the early morning and clockwise during the day with a moderate amplitude (40°-50°) around the synoptic wind direction. As the surface wind speed was much larger than the synoptic wind speed, such a case we have designated as a "synoptic breeze". The breeze onset was shown to fail several times under the influence of weak non-thermal events, e.g., the passage of an occluded front or clouds or an excess of convection. Finally, several local-scale influences of the complex coastal shape appeared in our measurements, e.g., wind fanning in the lee of the isthmus and airflow skirting around the peninsula forehand.

  1. Endoscopic vs. tactile evaluation of subgingival calculus.

    PubMed

    Osborn, Joy B; Lenton, Patricia A; Lunos, Scott A; Blue, Christine M

    2014-08-01

    Endoscopic technology has been developed to facilitate imagery for use during diagnostic and therapeutic phases of periodontal care. The purpose of this study was to compare the level of subgingival calculus detection using a periodontal endoscope with that of conventional tactile explorer in periodontitis subjects. A convenience sample of 26 subjects with moderate periodontitis in at least 2 quadrants was recruited from the University of Minnesota School of Dentistry to undergo quadrant scaling and root planing. One quadrant from each subject was randomized for tactile calculus detection alone and the other quadrant for tactile detection plus the Perioscope ™ (Perioscopy Inc., Oakland, Cali). A calculus index on a 0 to 3 score was performed at baseline and at 2 post-scaling and root planing visits. Sites where calculus was detected at visit 1 were retreated. T-tests were used to determine within-subject differences between Perioscope™ and tactile measures, and changes in measures between visits. Significantly more calculus was detected using the Perioscope™ vs. tactile explorer for all 3 subject visits (p<0.005). Mean changes (reduction) in calculus detection from baseline to visit 1 were statistically significant for both the Perioscope™ and tactile quadrants (p<0.0001). However, further reductions in calculus detection from visit 1 to visit 2 was only significant for the Perioscope™ quadrant (p<0.025), indicating that this methodology was able to more precisely detect calculus at this visit. It was concluded that the addition of a visual component to calculus detection via the Perioscope™ was most helpful in the re-evaluation phase of periodontal therapy. Copyright © 2014 The American Dental Hygienists’ Association.

  2. Evolving Patient Compliance Trends: Integrating Clinical, Insurance, and Extrapolated Socioeconomic Data

    PubMed Central

    Klobusicky, Joseph J.; Aryasomayajula, Arun; Marko, Nicholas

    2015-01-01

    Efforts toward improving patient compliance in medication focus on either identifying trends in patient features or studying changes through an intervention. Our study seeks to provide an important link between these two approaches through defining trends of evolving compliance. In addition to using clinical covariates provided through insurance claims and health records, we also extracted census based data to provide socioeconomic covariates such as income and population density. Through creating quadrants based on periods of medicine intake, we derive several novel definitions of compliance. These definitions revealed additional compliance trends through considering refill histories later in a patient’s length of therapy. These results suggested that the link between patient features and compliance includes a temporal component, and should be considered in policymaking when identifying compliant subgroups. PMID:26958212

  3. Totally laparoscopic radical BII gastrectomy for the treatment of gastric cancer: a comparison with open surgery.

    PubMed

    Lee, Wei-Jei; Wang, Weu; Chen, Tai-Chi; Chen, Jung-Chieh; Ser, Kong-Han

    2008-08-01

    Laparoscopically assisted distal gastrectomy has been used for distal part early gastric cancer resection. However, use of totally laparoscopic gastric cancer resection remains limited because of technical problems, especially when standard D2 nodal dissection was applied. We had reported the first totally laparoscopic Billroth II (BII) subtotal gastrectomy with lymphadenectomy for early gastric cancer in the year 1998. The aim of this study is to determine whether this procedure is superior to conventional open technique. The clinical course of 34 consecutive patients who underwent totally laparoscopic BII gastrectomy using an upper to lower, right to left, and clockwise quadrant-to-quadrant technique was compared with 34 sex-matched and age-matched patients who underwent open gastrectomy. Main outcome measures included operative time, blood loss, length of stay, morbidity and mortality, adequacy of lymphadenectomy, and long-term outcome. In the laparoscopic group, all the operations were completed by laparoscopic technique, but 1 patient required secondary laparotomy for total gastrectomy owing to inadequate resection margin. There was no operation mortality in this study. The postoperative complication rates were similar in these 2 groups. The mean operative time for laparoscopic group was 283+/-122 minutes (range: 186 to 480 min), significantly longer than the 195+/-26 minutes in the conventional group (P<0.001). Laparoscopic group was associated with less intraoperative blood loss (74 vs. 190 mL; P<0.01), early flatus passage (2.9 vs. 4.9 d; P<0.01), less usage of analgesics (3.5 vs. 5.8 doses; P<0.05), and a shorter postoperative hospital stay (8.5 vs. 12.1 d; P<0.01). There was no significant difference between laparoscopic and conventional open radical gastrectomy with regard to ratio of free margin, number of harvested lymph nodes, and survival. Although totally laparoscopic BII gastrectomy using the upper to lower technique required a longer surgical time and was technically more demanding than conventional open surgery, it resulted in shorter recovery time, less analgesic use, and less severe physical discomfort without compromising the operative curability and oncologic outcomes.

  4. Opportunity Rolls Free Again (Four Wheels)

    NASA Technical Reports Server (NTRS)

    2006-01-01

    This animated piece illustrates the recent escape of NASA's Mars Exploration Rover Opportunity from dangerous, loose material on the vast plains leading to the rover's next long-term target, 'Victoria Crater.'

    A series of images from the front and rear hazard-avoidance cameras make up this brief movie chronicling the challenge Opportunity faced to free itself from the ripple dubbed 'Jammerbugt.' Each quadrant shows one of the rover's four corner wheels: left front wheel in upper left, right front wheel in upper right, rear wheels in the lower quadrants. The wheels became partially embedded in the ripple at the end of a drive on Opportunity's 833rd Martian day, or sol (May 28, 2006). The images in this clip were taken on sols 836 through 841 (May 31 through June 5, 2006).

    Scientists and engineers who had been elated at the meters of progress the rover had been making in earlier drives were happy for even centimeters of advance per sol as they maneuvered their explorer through the slippery material of Jammerbugt. The wheels reached solid footing on a rock outcrop on the final sol of this sequence.

    The science and engineering teams appropriately chose the ripple's informal from name the name of a bay on the north coast of Denmark. Jammerbugt, or Jammerbugten, loosely translated, means Bay of Lamentation or Bay of Wailing. The shipping route from the North Sea to the Baltic passes Jammerbugt on its way around the northern tip of Jutland. This has always been an important trade route and many ships still pass by the bay. The prevailing wind directions are typically northwest to southwest with the strongest winds and storms tending to blow from the northwest. A northwesterly wind will blow straight into the Jammerbugt, towards shore. Therefore, in the age of sail, many ships sank there during storms. The shore is sandy, but can have strong waves, so running aground was very dangerous even though there are no rocks.

    Fortunately, Opportunity weathered its 'Jammerbugt' and is again on its way toward Victoria Crater.

  5. Ice-Penetrating Robot for Scientific Exploration

    NASA Technical Reports Server (NTRS)

    Zimmerman, Wayne; Carsey, Frank; French, Lloyd

    2007-01-01

    The cryo-hydro integrated robotic penetrator system (CHIRPS) is a partially developed instrumentation system that includes a probe designed to deeply penetrate the European ice sheet in a search for signs of life. The CHIRPS could also be used on Earth for similar exploration of the polar ice caps especially at Lake Vostok in Antarctica. The CHIRPS probe advances downward by a combination of simple melting of ice (typically for upper, non-compacted layers of an ice sheet) or by a combination of melting of ice and pumping of meltwater (typically, for deeper, compacted layers). The heat and electric power for melting, pumping, and operating all of the onboard instrumentation and electronic circuitry are supplied by radioisotope power sources (RPSs) and thermoelectric converters energized by the RPSs. The instrumentation and electronic circuitry includes miniature guidance and control sensors and an advanced autonomous control system that has fault-management capabilities. The CHIRPS probe is about 1 m long and 15 cm in diameter. The RPSs generate a total thermal power of 1.8 kW. Initially, as this power melts the surrounding ice, a meltwater jacket about 1 mm thick forms around the probe. The center of gravity of the probe is well forward (down), so that the probe is vertically stabilized like a pendulum. Heat is circulated to the nose by means of miniature pumps and heat pipes. The probe melts ice to advance in a step-wise manner: Heat is applied to the nose to open up a melt void, then heat is applied to the side to allow the probe to slip down into the melt void. The melt void behind the probe is allowed to re-freeze. Four quadrant heaters on the nose and another four quadrant heaters on the rear (upper) surface of the probe are individually controllable for steering: Turning on two adjacent nose heaters on the nose and two adjacent heaters on the opposite side at the rear causes melt voids to form on opposing sides, such that the probe descends at an angle from vertical. This steering capability can be used to avoid debris trapped in the ice or to maneuver closer to a trapped object of scientific interest.

  6. Breast surface radiation dose during coronary CT angiography: reduction by breast displacement and lead shielding.

    PubMed

    Foley, Shane J; McEntee, Mark F; Achenbach, Stephan; Brennan, Patrick C; Rainford, Louise S; Dodd, Jonathan D

    2011-08-01

    The purpose of this study was to prospectively evaluate the effect of cranial breast displacement and lead shielding on in vivo breast surface radiation dose in women undergoing coronary CT angiography. Fifty-four women (mean age, 59.2 ± 9.8 years) prospectively underwent coronary 64-MDCT angiography for evaluation of chest pain. The patients were randomly assigned to a control group (n = 16), breast displacement group (n = 22), or breast displacement plus lead shielding group (n = 16). Thermoluminescent dosimeters (TLDs) were placed superficially on each breast quadrant and the areolar region of both breasts. Breast surface radiation doses, the degree of breast displacement, and coronary image quality were compared between groups. A phantom dose study was conducted to compare breast doses with z-axis positioning on the chest wall. A total of 1620 TLD dose measurements were recorded. Compared with control values, the mean breast surface dose was reduced 23% in the breast displacement group (24.3 vs 18.6 mGy, p = 0.015) and 36% in the displacement plus lead shielding group (24.3 vs 15.6 mGy, p = 0.0001). Surface dose reductions were greatest in the upper outer (displacement alone, 66%; displacement plus shielding, 63%), upper inner (65%, 58%), and areolar quadrants (44%, 53%). The smallest surface dose reductions were recorded for A-cup breasts: 7% for the displacement group and 3% for the displacement plus lead group (p = 0.741). Larger reductions in surface dose were recorded for B-cup (25% and 56%, p = 0.273), C-cup (38% and 60%, p = 0.001), and D-cup (31% and 25%, p = 0.095) sizes. Most of the patients (79%) had either good (< 50% of breast above scan range) or excellent (< 75% of breast above the scan range) breast displacement. No significant difference in coronary image quality was detected between groups. The phantom dose study showed that surface TLD measurements were underestimates of absorbed tissue dose by a mean of 9% and that a strong negative correlation exists between the amount of cranial displacement and breast dose. Use of breast displacement during coronary CTA substantially reduces the radiation dose to the breast surface.

  7. Kinky thresholds revisited: opportunity costs differ in the NE and SW quadrants.

    PubMed

    Eckermann, Simon

    2015-02-01

    Historically, a kinked threshold line on the cost-effectiveness plane at the origin was suggested due to differences in willingness to pay (WTP) for health gain with trade-offs in the north-east (NE) quadrant versus willingness to accept (WTA) cost reductions for health loss with trade-offs in the south-west (SW) quadrant. Empirically, WTA is greater than WTP for equivalent units of health, a finding supported by loss aversion under prospect theory. More recently, appropriate threshold values for health effects have been shown to require an endogenous consideration of the opportunity cost of alternative actions in budget-constrained health systems, but also allocative and displacement inefficiency observed in health system practice. Allocative and displacement inefficiency arise in health systems where the least cost-effective program in contraction has a higher incremental cost-effectiveness ratio (ICER = m) than the most cost-effective program in expansion (ICER = n) and displaced services (ICER = d), respectively. The health shadow price derived by Pekarsky, [Formula: see text] reflects the opportunity cost of best alternative adoption and financing actions in reimbursing new technology with expected incremental costs and net effect allowing for allocative (n < m), and displacement, inefficiency (d < m). This provides an appropriate threshold value for the NE quadrant. In this paper, I show that for trade-offs in the SW quadrant, where new strategies have lower expected net cost while lower expected net effect than current practice, the opportunity cost is contraction of the least cost-effective program, with threshold ICER m. That is, in the SW quadrant, the cost reduction per unit of decreased effect should be compared with the appropriate opportunity cost, best alternative generation of funding. Consequently, appropriate consideration of opportunity cost produces a kink in the threshold at the origin, with the health shadow price in the NE quadrant and ICER of the least cost-effective program in contraction (m) in the SW quadrant having the same general shape as that previously suggested by WTP versus WTA. The extent of this kink depends on the degree of allocative and displacement inefficiency, with no kink in the threshold line strictly only appropriate with complete allocative and displacement efficiency, that is n = d = m.

  8. The medial temporal lobe—conduit of parallel connectivity: a model for attention, memory, and perception

    PubMed Central

    Mozaffari, Brian

    2014-01-01

    Based on the notion that the brain is equipped with a hierarchical organization, which embodies environmental contingencies across many time scales, this paper suggests that the medial temporal lobe (MTL)—located deep in the hierarchy—serves as a bridge connecting supra- to infra—MTL levels. Bridging the upper and lower regions of the hierarchy provides a parallel architecture that optimizes information flow between upper and lower regions to aid attention, encoding, and processing of quick complex visual phenomenon. Bypassing intermediate hierarchy levels, information conveyed through the MTL “bridge” allows upper levels to make educated predictions about the prevailing context and accordingly select lower representations to increase the efficiency of predictive coding throughout the hierarchy. This selection or activation/deactivation is associated with endogenous attention. In the event that these “bridge” predictions are inaccurate, this architecture enables the rapid encoding of novel contingencies. A review of hierarchical models in relation to memory is provided along with a new theory, Medial-temporal-lobe Conduit for Parallel Connectivity (MCPC). In this scheme, consolidation is considered as a secondary process, occurring after a MTL-bridged connection, which eventually allows upper and lower levels to access each other directly. With repeated reactivations, as contingencies become consolidated, less MTL activity is predicted. Finally, MTL bridging may aid processing transient but structured perceptual events, by allowing communication between upper and lower levels without calling on intermediate levels of representation. PMID:25426036

  9. Retinal Nerve Fiber Layer and Peripapillary Choroidal Thicknesses in Non-Glaucomatous Unilateral Optic Atrophy Compared with Unilateral Advanced Pseudoexfoliative Glaucoma.

    PubMed

    Kucukevcilioglu, Murat; Ayyildiz, Onder; Aykas, Seckin; Gokce, Gokcen; Koylu, Mehmet Talay; Ozgonul, Cem; Ozge, Gokhan; Mumcuoglu, Tarkan; Yumusak, Erhan

    2017-02-01

    To investigate retinal nerve fiber layer thickness (RNFL-T) and peripapillary choroidal thickness (PC-T) in non-glaucomatous optic atrophy (OA) patients in comparison with unaffected and control eyes, furthermore, to compare thickness profiles with unilateral pseudoexfoliative advanced glaucoma. Thirty-three eyes with OA (Group A), 33 unaffected fellow eyes (Group B), 25 right eyes of 25 control subjects (Group C), and 15 eyes with advanced glaucoma (Group D) were enrolled. RNFL-T was measured in six regions by spectral-domain optical coherence tomography. Enhanced depth imaging optical coherence tomography was obtained to evaluate PC-T in corresponding regions. RNFL-T was significantly lower in Group A than in Groups B and C globally and at all peripapillary regions (all p < 0.001). P-CT in Group A was significantly lower globally (p = 0.03) and in three regions (temporal, p = 0.001; temporal-superior, p = 0.01; and nasal-inferior, p = 0.037) versus Group C. However, it was significantly thinner than in Group B in all regions (temporal, p = 0.02; temporal-superior, p = 0.013; nasal-superior, p = 0.044; nasal, p = 0.02; nasal-inferior, p < 0.001; and temporal-inferior, p < 0.001) and globally (p < 0.001). In Group A RNFL-T (thicker superiorly and inferiorly; thinner temporally and nasally) and PC-T (superior > temporal > nasal > inferior) profiles were almost identical to that in unaffected fellow eyes and control eyes. However, Group D showed different patterns with less regional differences in RNFL-T, and the greatest value of PC-T in nasal quadrant. Besides retinal nerve fiber layer thinning, non-glaucomatous OA is associated with choroidal thinning. The RNFL-T and PC-T profiles in advanced glaucoma eyes differed from the common patterns seen among OA eyes, unaffected fellow eyes, and control eyes.

  10. Temporal and Spatial Patterns of Neural Activity Associated with Information Selection in Open-ended Creativity.

    PubMed

    Zhou, Siyuan; Chen, Shi; Wang, Shuang; Zhao, Qingbai; Zhou, Zhijin; Lu, Chunming

    2018-02-10

    Novel information selection is a crucial process in creativity and was found to be associated with frontal-temporal functional connectivity in the right brain in closed-ended creativity. Since it has distinct cognitive processing from closed-ended creativity, the information selection in open-ended creativity might be underlain by different neural activity. To address this issue, a creative generation task of Chinese two-part allegorical sayings was adopted, and the trials were classified into novel and normal solutions according to participants' self-ratings. The results showed that (1) novel solutions induced a higher lower alpha power in the temporal area, which might be associated with the automatic, unconscious mental process of retrieving extensive semantic information, and (2) upper alpha power in both frontal and temporal areas and frontal-temporal alpha coherence were higher in novel solutions than in normal solutions, which might reflect the selective inhibition of semantic information. Furthermore, lower alpha power in the temporal area showed a reduction with time, while the frontal-temporal and temporal-temporal coherence in the upper alpha band appeared to increase from the early to the middle phase. These dynamic changes in neural activity might reflect the transformation from divergent thinking to convergent thinking in the creative progress. The advantage of the right brain in frontal-temporal connectivity was not found in the present work, which might result from the diversity of solutions in open-ended creativity. Copyright © 2017 IBRO. Published by Elsevier Ltd. All rights reserved.

  11. 64. VIEW FROM THE NORTHEAST IN THE NORTHEAST QUADRANT. DETAIL ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    64. VIEW FROM THE NORTHEAST IN THE NORTHEAST QUADRANT. DETAIL VIEW OF THE RIGHT FACE. A PORTION OF THE RIGHT SHOULDER ANGLE IS INCLUDED ON THE LEFT-SIDE OF THE IMAGE, WITH SCALE. - Fort Sumter, Charleston, Charleston County, SC

  12. Self-assessing target with automatic feedback

    DOEpatents

    Larkin, Stephen W.; Kramer, Robert L.

    2004-03-02

    A self assessing target with four quadrants and a method of use thereof. Each quadrant containing possible causes for why shots are going into that particular quadrant rather than the center mass of the target. Each possible cause is followed by a solution intended to help the marksman correct the problem causing the marksman to shoot in that particular area. In addition, the self assessing target contains possible causes for general shooting errors and solutions to the causes of the general shooting error. The automatic feedback with instant suggestions and corrections enables the shooter to improve their marksmanship.

  13. Investigation of several aspects of LANDSAT-4 data quality. [Sacramento, San Francisco, and NE Arkansas

    NASA Technical Reports Server (NTRS)

    Wrigley, R. C. (Principal Investigator)

    1984-01-01

    The Thematic Mapper scene of Sacramento, CA acquired during the TDRSS test was received in TIPS format. Quadrants for both scenes were tested for band-to-band registration using reimplemented block correlation techniques. Summary statistics for band-to-band registrations of TM band combinations for Quadrant 4 of the NE Arkansas scene in TIPS format are tabulated as well as those for Quadrant 1 of the Sacramento scene. The system MTF analysis for the San Francisco scene is completed. The thermal band did not have sufficient contrast for the targets used and was not analyzed.

  14. Nuclear Graphite - Fracture Behavior and Modeling

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

    Burchell, Timothy D; Battiste, Rick; Strizak, Joe P

    2011-01-01

    Evidence for the graphite fracture mechanism is reviewed and discussed. The roles of certain microstructural features in the graphite fracture process are reported. The Burchell fracture model is described and its derivation reported. The successful application of the fracture model to uniaxial tensile data from several graphites with widely ranging structure and texture is reported. The extension of the model to multiaxial loading scenarios using two criteria is discussed. Initially, multiaxial strength data for H-451 graphite were modeled using the fracture model and the Principle of Independent Action. The predicted 4th stress quadrant failure envelope was satisfactory but the 1stmore » quadrant predictions were not conservative and thus were unsatisfactory. Multiaxial strength data from the 1st and 4th stress quadrant for NBG-18 graphite are reported. To improve the conservatism of the predicted 1st quadrant failure envelope for NBG-18 the Shetty criterion has been applied to obtain the equivalent critical stress intensity factor, KIc (Equi), for each applied biaxial stress ratio. The equivalent KIc value is used in the Burchell fracture model to predict the failure envelope. The predicted 1st stress quadrant failure envelope is conservative and thus more satisfactory than achieved previously using the fracture model combined with the Principle of Independent Action.« less

  15. Genesis Silicon Carbide Concentrator Target 60003 Preliminary Ellipsometry Mapping Results

    NASA Technical Reports Server (NTRS)

    Calaway, M. J.; Rodriquez, M. C.; Stansbery, E. K.

    2007-01-01

    The Genesis concentrator was custom designed to focus solar wind ions primarily for terrestrial isotopic analysis of O-17/O-16 and O-18/O-16 to +/-1%, N-15/N-14 to +/-1%, and secondarily to conduct elemental and isotopic analysis of Li, Be, and B. The circular 6.2 cm diameter concentrator target holder was comprised of four quadrants of highly pure semiconductor materials that included one amorphous diamond-like carbon, one C-13 diamond, and two silicon carbide (SiC). The amorphous diamond-like carbon quadrant was fractured upon impact at Utah Test and Training Range (UTTR), but the remaining three quadrants survived fully intact and all four quadrants hold an important collection of solar wind. The quadrants were removed from the target holder at NASA Johnso n Space Center Genesis Curation Laboratory in April 2005, and have been housed in stainless steel containers under continual nitrogen purge since time of disintegration. In preparation for allocation of a silicon carbide target for oxygen isotope analyses at UCLA, the two SiC targets were photographed for preliminary inspection of macro particle contamination from the hard non-nominal landing as well as characterized by spectroscopic ellipsometry to evaluate thin film contamination. This report is focused on Genesis SiC target sample number 60003.

  16. High precision dual-axis tracking solar wireless charging system based on the four quadrant photoelectric sensor

    NASA Astrophysics Data System (ADS)

    Liu, Zhilong; Wang, Biao; Tong, Weichao

    2015-08-01

    This paper designs a solar automatic tracking wireless charging system based on the four quadrant photoelectric sensor. The system track the sun's rays automatically in real time to received the maximum energy and wireless charging to the load through electromagnetic coupling. Four quadrant photoelectric sensor responsive to the solar spectrum, the system could get the current azimuth and elevation angle of the light by calculating the solar energy incident on the sensor profile. System driver the solar panels by the biaxial movement mechanism to rotate and tilt movement until the battery plate and light perpendicular to each other. Maximize the use of solar energy, and does not require external power supply to achieve energy self-sufficiency. Solar energy can be collected for portable devices and load wireless charging by close electromagnetic field coupling. Experimental data show that: Four quadrant photoelectric sensor more sensitive to light angle measurement. when track positioning solar light, Azimuth deviation is less than 0.8°, Elevation angle deviation is less than 0.6°. Use efficiency of a conventional solar cell is only 10% -20%.The system uses a Four quadrant dual-axis tracking to raise the utilization rate of 25% -35%.Wireless charging electromagnetic coupling efficiency reached 60%.

  17. Retinal oxygen saturation in Chinese adolescents.

    PubMed

    Liu, Xue; Wang, Shuang; Liu, Yi; Liu, Li Juan; Lv, Yan Yun; Tang, Ping; Jonas, Jost B; Xu, Liang

    2017-02-01

    To study the retinal oxygen saturation in normal eyes of Chinese adolescents. Performing retinal oximetry with the Oxymap T1 Retinal Oximeter in healthy children and adolescents (aged 5-18 years old), we measured the arterial (SaO 2 ) and venular (SvO 2 ) oxygen saturation and the arteriovenous difference in oxygen saturation (Sa-vO 2 ). The study included 122 individuals with a mean age of 13.0 ± 2.9 years (range: 5-18 years) and a mean refractive error of -3.25 ± 2.49 dioptres (range:-8.88 to +3.13 dioptres). Mean SaO 2 , SvO 2 and Sa-vO 2 was 85.5 ± 7.1%, 48.2 ± 5.5% and 37.3 ± 6.5%, respectively. Mean SaO 2 was significantly (p < 0.001) the lowest in the inferotemporal quadrant (79.1 ± 9.0%), followed by the superotemporal quadrant (83.4 ± 9.7%), the inferonasal quadrant (90.4 ± 10.6%) and the superonasal quadrant (93.4 ± 10.8%). In a similar manner, the values of the SvO 2 were the lowest (p < 0.001) in the inferotemporal quadrant (42.1 ± 8.3%), followed by the superotemporal quadrant (47.8 ± 7.2%), the inferonasal quadrant (52.3 ± 8.4%) and the superonasal quadrant (55.1 ± 7.6%). Arteriovenous difference in oxygen saturation (Sa-vO 2 ) did not differ significantly (all p > 0.05) between the fundus quadrants. In multiple linear regression analysis, SaO 2 increased (regression coefficient r 2  = 0.28) with older age (standardized regression coefficient β: 0.23; p = 0.01) and more myopic refractive error (β: -0.39; p < 0.001). Higher SvO 2 was significantly correlated with more myopic refractive error (β: -0.46; p < 0.001; r 2  = 0.20), while Sa-vO 2 increased significantly only with older age in the multivariate analysis (β: 0.26; p = 0.01; r 2  = 0.07). Our study provides normative data for Chinese children and adolescents who showed lower values than adults for SaO 2 and SvO 2 . SaO 2 increased with older age and higher myopic refractive error, SvO 2 increased with higher myopic refractive error, and Sa-vO 2 increased with older age. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  18. Right upper-quadrant pain in a patient with drug abuse, secondary syphilis and occult hepatitis B virus.

    PubMed

    Fielding, Cory M; Angulo, Paul

    2014-01-01

    To describe the etiology of hepatitis and identify occult hepatitis B virus (HBV) infection. A 40-year-old man presented with severe abdominal pain and jaundice, a history of acute HBV infection that had cleared as well as the use of acetaminophen, methamphetamine, buprenorphine and marijuana. He admitted to having had unprotected sex with multiple partners of both genders. A thorough skin examination revealed papulosquamous lesions on his penis, scrotum, upper and lower extremities and feet. Transaminases and bilirubin were elevated. His rapid plasma reagin was reactive, and hepatitis serologies showed occult HBV. Liver biopsy showed severe hepatitis, but the stains for hepatitis B surface antigen and hepatitis B core antigen were negative. The pathological findings were highly indicative of drug-induced hepatitis without evidence of chronic hepatitis, reactivation of HBV or syphilitic hepatitis. With supportive management and abstinence from drugs, his condition improved. This case describes a patient with multiple potential causes for hepatitis and highlights the importance of obtaining a detailed social history. Further, one should consider the presence of occult HBV and recognize the serologic pattern. © 2014 S. Karger AG, Basel.

  19. Synoptic climatology of the long-distance dispersal of white pine blister rust I. Development of an upper level synoptic classification

    Treesearch

    K. L. Frank; L. S. Kalkstein; B. W. Geils; H. W. Thistle

    2008-01-01

    This study developed a methodology to temporally classify large scale, upper level atmospheric conditions over North America, utilizing a newly-developed upper level synoptic classification (ULSC). Four meteorological variables: geopotential height, specific humidity, and u- and v-wind components, at the 500 hPa level over North America were obtained from the NCEP/NCAR...

  20. A study of lip print pattern in Goan dental students - A digital approach.

    PubMed

    Prabhu, Rachana V; Dinkar, Ajit; Prabhu, Vishnudas

    2012-10-01

    To find the incidence of different types of lip patterns, the dominant pattern, quadrant wise, amongst the Goan population. To assess, the quadrant wise differences in lip patterns among males and females and to report new lip print pattern in Goan population. Lip prints of 100 students studying in Goa Dental College & Hospital were taken using 14 mm wide and 50 mm long Scotch tape without any distortion. These prints were then scanned (256 gray shades at a resolution of 300 dpi.) for the digital analysis. Using various applications of Adobe Photoshop 7 software an attempt was made to trace each and every line. K. Suzuki and Y. Tsuchihashi's classification was followed to define the patterns of the grooves. The current study has found the most predominant pattern in Quadrant I to be Type V (580 lines; 52.39%) followed in order by Type I' (196 lines; 17.70%), Type I (166 lines; 14.99%), Type II (166 lines; 10.47%), Type IV (40 lines; 3.61%), Type III (9 lines; 0.81%). In Quadrant II of this study the most predominant pattern recorded was Type V (589 lines; 50.47%) followed in order by Type I' (209 lines; 17.90%), Type I (204 lines; 17.48%), Type II (130 lines; 11.13%), Type IV (34 lines; 2.91%), Type III (1 line; 0.08%). In Quadrant III of this study the most predominant pattern recorded was again Type V (484 lines; 52.09%) followed in order by Type I' (174 lines; 18.72%), Type I (155 lines; 16.68%), Type II (102 lines; 10.97%), Type IV (9 lines; 0.96%), Type III (5 lines; 0.53%). In Quadrant IV of this study the most predominant pattern recorded was Type V (543 lines; 58.19%) followed in order by Type I (151 lines; 16.18%), Type I' (138 lines; 14.79%), Type II (85 lines; 9.11%), Type III (9 lines; 0.96%), Type IV (7 line; 0.75%). In all four Quadrants the most predominant pattern found in males and females was Type V. The present study recorded the following types of type V patterns for the first time; Trifurcations, Bridge or 'H' pattern, Horizontal Lines, Cartwheel, Pineapple Skin and Multiple Branching Appearance. The digital method of analyzing the Lip Print images using Adobe Photoshop 7 software serves as a convenient method that provides better visualization and ease in identification and recording of the Lip Print pattern. Predominant pattern in all four quadrants was Type V followed by the linear pattern i.e. Type I' in quadrants I, II, and III and Type I in quadrant IV in the studied population. Distribution of pattern is not affected by the sex. Although type V is the most predominant pattern found in Goan population, the sub-classification of this type defines the more defined term and aids in accuracy of the classification. Copyright © 2012. Published by Elsevier Ltd.

  1. Build-It-Yourself Astronomy.

    ERIC Educational Resources Information Center

    Lamb, William G.

    1983-01-01

    Instructions for constructing cross staffs and quadrants are provided. Astronomy teaching methods using the two devices are discussed. These include locating common constellations with the cross staff and following a star (or moon, sun, or planets) by reading the altitude and azimuth with the quadrant. (JN)

  2. Northeastern Quadrant of the Caloris Basin

    NASA Image and Video Library

    2000-01-14

    This image, from NASA Mariner 10 spacecraft which launched in 1974, is of the northeastern quadrant of the Caloris basin and shows the smooth hills and domes between the inner and outer scarps and the well-developed radial system east of the outer scarp

  3. Diagnostic Capability of Peripapillary Retinal Thickness in Glaucoma Using 3D Volume Scans

    PubMed Central

    Simavli, Huseyin; Que, Christian John; Akduman, Mustafa; Rizzo, Jennifer L.; Tsikata, Edem; de Boer, Johannes F.; Chen, Teresa C.

    2015-01-01

    Purpose To determine the diagnostic capability of spectral domain optical coherence tomography (SD-OCT) peripapillary retinal thickness (RT) measurements from 3-dimensional (3D) volume scans for primary open angle glaucoma (POAG). Design Cross-sectional study. Methods Setting Institutional Study population 156 patients (89 POAG and 67 normal subjects) Observation procedures One eye of each subject was included. SD-OCT peripapillary RT values from 3D volume scans were calculated for four quadrants of three different sized annuli. Peripapillary retinal nerve fiber layer (RNFL) thickness values were also determined. Main outcome measures Area under the receiver operating characteristic curve (AUROC) values, sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios. Results The top five RT AUROCs for all glaucoma patients and for a subset of early glaucoma patients were for the inferior quadrant of outer circumpapillary annulus of circular grid (OCA) 1 (0.959, 0.939), inferior quadrant of OCA2 (0.945, 0.921), superior quadrant of OCA1 (0.890, 0.811), inferior quadrant of OCA3 (0.887, 0.854), and superior quadrant of OCA2 (0.879, 0.807). Smaller RT annuli OCA1 and OCA2 consistently showed better diagnostic performance than the larger RT annulus OCA3. For both RNFL and RT measurements, best AUROC values were found for inferior RT OCA1 and OCA2, followed by inferior and overall RNFL thickness. Conclusion Peripapillary RT measurements from 3D volume scans showed excellent diagnostic performance for detecting both glaucoma and early glaucoma patients. Peripapillary RT values have the same or better diagnostic capability compared to peripapillary RNFL thickness measurements, while also having fewer algorithm errors. PMID:25498354

  4. Role of "diseased" root cementum in healing following treatment of periodontal disease. A clinical study.

    PubMed

    Nyman, S; Westfelt, E; Sarhed, G; Karring, T

    1988-08-01

    This clinical trial was undertaken to examine whether root debridement in the treatment of periodontal disease must include the removal of the exposed cementum in order to achieve periodontal health. The study included 11 adult patients with moderate to advanced periodontal disease. In a split-mouth design, the dentition of each patient was by random selection divided into test- and control quadrants comprising the incisors, canines and premolars. Following a baseline examination, all patients were given a case presentation and a detailed instruction in self-performed oral hygiene measures. The patients were then subjected to periodontal surgery. Following reverse bevel incisions, buccal and lingual mucoperiosteal flaps were elevated and all granulation tissue was removed. In 2 jaw quadrants (control quadrants) in each patient, the denuded root surfaces were carefully scaled and planed in order to remove soft and hard deposits as well as all cementum, using hand instruments and flame-formed diamond stones. In the contralateral quadrants (test quadrants) the roots were not scaled and planed but soft microbial deposits were removed by polishing the root surfaces with the but soft microbial deposits were removed by polishing the root surfaces with the use of rubber cups, interdental rubber tips and a polishing paste. Calculus in the test quadrants was removed by the use of a curette, but precaution was taken to avoid the removal of cementum. The flaps were repositioned to their original level and sutured. The patients were following active treatment enrolled in a supervised maintenance care program including "professional tooth cleaning" once every 2 weeks for a 3-month period.(ABSTRACT TRUNCATED AT 250 WORDS)

  5. Demonstration of angle widening using EyeCam after laser peripheral iridotomy in eyes with angle closure.

    PubMed

    Perera, Shamira A; Quek, Desmond T; Baskaran, Mani; Tun, Tin A; Kumar, Rajesh S; Friedman, David S; Aung, Tin

    2010-06-01

    To evaluate EyeCam in detecting changes in angle configuration after laser peripheral iridotomy (LPI) in comparison to gonioscopy, the reference standard. Prospective comparative study. Twenty-four subjects (24 eyes) with primary angle-closure glaucoma (PACG) were recruited. Gonioscopy and EyeCam (Clarity Medical Systems) imaging of all 4 angle quadrants were performed, before and 2 weeks after LPI. Images were graded according to angle structures visible by an observer masked to clinical data or the status of LPI, and were performed in a random order. Angle closure in a quadrant was defined as the inability to visualize the posterior trabecular meshwork. We determined the number of quadrants with closed angles and the mean number of clock hours of angle closure before and after LPI in comparison to gonioscopy. Using EyeCam, all 24 eyes showed at least 1 quadrant of angle widening after LPI. The mean number of clock hours of angle closure decreased significantly, from 8.15 +/- 3.47 clock hours before LPI to 1.75 +/- 2.27 clock hours after LPI (P < .0001, Wilcoxon signed rank test). Overall, gonioscopy showed 1.0 +/- 1.41 (95% CI, 0.43-1.57) quadrants opening from closed to open after LPI compared to 2.0 +/- 1.28 (95% CI, 1.49-2.51, P = .009) quadrants with EyeCam. Intra-observer reproducibility of grading the extent of angle closure in clock hours in EyeCam images was moderate to good (intraclass correlation coefficient 0.831). EyeCam may be used to document changes in angle configuration after LPI in eyes with PACG. Copyright 2010 Elsevier Inc. All rights reserved.

  6. One-year clinical results of Er,Cr:YSGG laser application in addition to scaling and root planing in patients with early to moderate periodontitis.

    PubMed

    Kelbauskiene, Solveiga; Baseviciene, Nomeda; Goharkhay, Kawe; Moritz, Andreas; Machiulskiene, Vita

    2011-07-01

    In 30 patients with periodontitis, a total of 278 teeth exhibiting bleeding on probing, subgingival calculus, and a probing depth between 3-6 mm were examined. For each participant, two treatment types were alternatively applied on the contralateral quadrants: scaling and root planing (SRP) as control, and SRP followed by Er,Cr:YSGG laser application (SRP+laser), as a test method. Five clinical parameters: plaque level, bleeding on probing, probing depth, gingival recession and clinical attachment level were examined at baseline and at 2, 3, 6, 12 months after treatment. Of the total of 1,668 sites examined in all patients, 1,088 sites were found with a probing depth of 3-6 mm. In these sites, differences in clinical parameters between SRP and SRP+laser-treated quadrants were analyzed, assuming the level of p < 0.05 as significant. After 2 months from baseline, the mean probing depth reduction and the clinical attachment level gain were significantly greater in SRP+laser than in SRP quadrants, and remained so throughout the study (p < 0.001). A marked reduction of the bleeding scores occurred in all examined sites, irrespective of the treatment method. However, after 12 months, significantly less teeth exhibited bleeding on probing in SRP+laser quadrants than in SRP quadrants (p < 0.001). The mean plaque and gingival recession levels did not differ between the SRP and SRP+laser quadrants neither before nor after the treatment. The periodontal procedures either using Er,Cr:YSGG laser after SRP or SRP alone, lead to significant improvements in all clinical parameters investigated. However, laser application, as an adjunct to SRP, appeared to be more advantageous.

  7. Histostitcher™: An informatics software platform for reconstructing whole-mount prostate histology using the extensible imaging platform framework

    PubMed Central

    Toth, Robert J.; Shih, Natalie; Tomaszewski, John E.; Feldman, Michael D.; Kutter, Oliver; Yu, Daphne N.; Paulus, John C.; Paladini, Ginaluca; Madabhushi, Anant

    2014-01-01

    Context: Co-registration of ex-vivo histologic images with pre-operative imaging (e.g., magnetic resonance imaging [MRI]) can be used to align and map disease extent, and to identify quantitative imaging signatures. However, ex-vivo histology images are frequently sectioned into quarters prior to imaging. Aims: This work presents Histostitcher™, a software system designed to create a pseudo whole mount histology section (WMHS) from a stitching of four individual histology quadrant images. Materials and Methods: Histostitcher™ uses user-identified fiducials on the boundary of two quadrants to stitch such quadrants. An original prototype of Histostitcher™ was designed using the Matlab programming languages. However, clinical use was limited due to slow performance, computer memory constraints and an inefficient workflow. The latest version was created using the extensible imaging platform (XIP™) architecture in the C++ programming language. A fast, graphics processor unit renderer was designed to intelligently cache the visible parts of the histology quadrants and the workflow was significantly improved to allow modifying existing fiducials, fast transformations of the quadrants and saving/loading sessions. Results: The new stitching platform yielded significantly more efficient workflow and reconstruction than the previous prototype. It was tested on a traditional desktop computer, a Windows 8 Surface Pro table device and a 27 inch multi-touch display, with little performance difference between the different devices. Conclusions: Histostitcher™ is a fast, efficient framework for reconstructing pseudo WMHS from individually imaged quadrants. The highly modular XIP™ framework was used to develop an intuitive interface and future work will entail mapping the disease extent from the pseudo WMHS onto pre-operative MRI. PMID:24843820

  8. Evaluation of Central Macular Thickness and Retinal Nerve Fiber Layer Thickness using Spectral Domain Optical Coherence Tomography in a Tertiary Care Hospital

    PubMed Central

    Saini, VK; Gupta, Saroj; Sharma, Anjali

    2014-01-01

    ABSTRACT Purpose: To evaluate the normative data of macular thickness and retinal nerve fiber layer thickness (RNFL) among normal subjects using spectral domain optical coherence tomography (OCT). Materials and methods: Normal subjects presenting to a tertiary medical hospital were included in the study. All patient underwent clinical examination followed by study of macular thickness and RN FL thick ness by spectral domain Topc on OCT. The data was collected and analyzed for variations in gender and age. The data was also compared with available literature. Results: Total numbers of patients enrolled in the study were 154 (308 eyes). Numbers of males were 79 (158 eyes) and numbers of females were 75 (150 eyes). The mean age among males was 42.67 ± 12.15 years and mean age among females was 42.88 ± 11.73 years. Overall the mean mac ular thickness (central 1 mm zone) with SD - OCT was 241.75 ± 17.3 microns. The mean macular volume was 7.6 cu. mm ± 0.33. On analysis of the RNFL thickness, we observed that the RNFL was thickest in the inferior quadrant (138.58) followed by superior (122.30) nasal (116.32) and temporal quadrant (73.04). Gender-wise comparison of the data revealed no statistically significant difference for age, macular thickness parameters, volume and RFNL values except outer temporal thickness among males and females. No age-related difference was noted in the above parameters. On comparison with available norma tive data from India and elsewhere, we found significant variations with different machines. Conclusion: The study is the first to provide normative data using SD-OCT from central India. The data from spectral domain OCT correlated well with the values obtained from similar studies with SD - OCT. Values obtained from time domain OCT machines are different and are not comparable. How to cite this article: Agarwal P, Saini VK, Gupta S, Sharma A. Evaluation of Central Macular Thickness and Retinal Nerve Fiber Layer Thickness using Spectral Domain Optical Coherence Tomography in a Tertiary Care Hospital. J Curr Glaucoma Pract 2014;8(2):75-81. PMID:26997813

  9. [Splenic infarction].

    PubMed

    Cuquerella, J; Ferrer, L; Rivera, P; Tuset, J A; Medina, E; Pamós, S; Ariete, V; Tomé, A; García, V

    1996-06-01

    A 53-year-old male suffered splenic infarction etiologically related to atrial fibrillation and non-obstructive hypertrophic cardiomyopathy. The main clinical manifestations were a one-month history of epigastric and left upper quadrant pain, with tenderness to palpation in the later zone. Laboratory tests revealed a slight leucocytosis (14.700) with left shift and a marked increase in LDH concentration (945 IU). Abdominal CAT and arteriography established the diagnosis, Echography proved normal. Patient evolution was satisfactory with conservative medical treatment. We conclude that splenic infarction should be considered in all cases of acute or chronic pain in the left hypochondrium. The diagnosis is established by CAT, arteriography and hepatosplenic gammagraphy. Medical management is initially advocated, surgery being reserved for those cases involving complications or in which diagnosis is not clear. Emphasis is placed on the main etiological, clinical, diagnostic and management characteristics of splenic infarction.

  10. Sonographic anatomy of the gastrohepatic ligament.

    PubMed

    Desai, Gaurav; Filly, Roy A

    2010-01-01

    The purpose of this presentation is to illustrate anatomic and pathologic features of the gastrohepatic ligament (GHL) and to show its usefulness for precise localization of abnormalities, particularly in relation to the lesser peritoneal cavity and diseases occurring within the confines of the ligament itself. Cases were selected that illustrate the objectives above. Illustrations show various anatomic and pathologic features meant to enhance interpretation of left upper quadrant sonograms. Illustrations seen in the sonographic literature vaguely interpret the relationships of the GHL. Misunderstanding has led not only to improper nomenclature but also to the use of inappropriate indicators of lesser omental diseases. With a clear understanding of the anatomy of the GHL and its use as a pivotal marker for structures around and within it, one can avoid these pitfalls and better evaluate adult and pediatric lesser omental anatomy.

  11. A rare case of hepatic duct injury from blunt abdominal trauma.

    PubMed

    Hasaniya, Nahidh W; Premaratne, Shyamal; Premaratne, Ishani D; McNamara, J Judson

    2013-01-01

    A 25 year-old male was brought to the emergency room following an apparent suicide attempt by jumping from the fourth floor. Patient had a large abdominal laceration in the right upper quadrant (RUQ). CT scan showed a sub-scapular hematoma of the liver. Due to the repeated episodes of hypotension, a laporotomy was performed and the left hepatic artery was ligated while the ductal injury was managed with a Roux-en-Y left hepatic jejunostomy and stent. Bile leakage was resolved post-operatively by day 5 and the patient was discharged home on day 13 after clearance from psychiatry. While non-iatrogenic extrahepatic biliary trauma is rare, a high degree of suspicion is essential, especially in cases like the one discussed in this report. Diagnosis can be difficult in patients undergoing observation.

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

    Heck, L.L.; Brittin, G.M.

    A 19-year-old black woman with sickle cell beta degrees thalassemia had experienced more than 100 hospital admissions for sickle cell crisis and aseptic necrosis of both femoral heads. Her spleen was enlarged threefold and accumulated both radiocolloid and bone-seeking agent on two occasions, demonstrating an exception to the rule in sickle cell anemia that spleens that take up bone-seeking agents demonstrate functional asplenia. In the context of fever, left upper quadrant pain, and splenomegaly, the pattern of calcification in the patient's spleen as revealed in ultrasound and CT studies suggested possible abscess and led to unnecessary splenectomy. The nuclear medicinemore » studies did not support this diagnosis. Nuclear medicine physicians should not be misled by splenic findings of sickle cell thalassemia (and possibly of other heterozygous sickle cell disorders) that differ from those of the more familiar homozygous sickle cell anemia.« less

  13. [Undifferentiated (embryonal) sarcoma of the liver. Report of a case].

    PubMed

    Orozco, H; Mercado, M A; Takahashi, T; Chan, C; Quintanilla, L; Jiménez, M; Sosa, R; Esquivel, E

    1991-01-01

    A 15-year-old woman who was studied because an abdominal mass at the Instituto Nacional de la Nutricion Salvador Zubiran (INNSZ) is reported. The history revealed only malaise and mild abdominal pain. At physical exploration, an abdominal mass in the upper right quadrant was found. Liver function tests were normal. Abdominal ultrasound and computerized tomography revealed a large cystic mass of the right hepatic lobe. She underwent exploratory laparotomy. Intraoperative frozen sections of the biopsies demonstrated undifferentiated sarcoma of the liver, and an extended right trisegmentectomy was performed. Postoperative outcome was uneventful. Adjuvant treatment with doxorubicin and dacarbazine was given, and at six months of follow-up, the patient is alive without any evidence of recurrence. Clinical and histopathologic features of this rare malignant tumor are discussed, as well as the therapeutic choices.

  14. Gastric air contrast: useful adjunct to hepatic artery scintigraphy

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

    Wahl, R.L.; Ziessman, H.A.; Juni, J.

    The utility of scintigraphic views obtained after administration of sodium bicarbonate-citric acid-simethicone crystals (E-Z-GAS) for the determination of gastric extrahepatic perfusion was evaluated in 20 technetium-99m macroaggregated albumin hepatic arterial perfusion studies performed in 19 patients. These crystals produce carbon dioxide gas, distend the stomach, and allow better delineation of gastric activity (extrahepatic perfusion to the stomach). Conversely, a lack of change in activity in the left upper quadrant after the effervescent crystals have been ingested suggests no gastric activity (and no extrahepatic perfusion to the stomach). These air-contrast views added useful information in 16 of 20 studies. Air contrastmore » views of the stomach can be extremely helpful in verifying or excluding the diagnosis of gastric extrahepatic perfusion on technetium-99m macroaggregated albumin hepatic arterial perfusion studies.« less

  15. Villous adenoma of the common hepatic duct: the importance of contrast-enhanced ultrasound and endoscopic retrograde cholangiopancreatography for relevant diagnosis. A case report and review of the literature.

    PubMed

    Tefas, Cristian; Tanţău, Marcel; Szenftleben, Alexandru; Chiorean, Liliana; Badea, Radu

    2015-12-01

    Adenomas are frequently encountered in the lower digestive tract but are rarely diagnosed in the biliary tree. We report a case of villous adenoma of the common hepatic duct. A 58-year old male was admitted with a four week history of intermittent upper right quadrant pain. Gray scale and contrast-enhanced abdominal ultrasound showed a mass inside the common hepatic duct with arterial enhancement and slow wash-out during the late venous phase. Subsequent endoscopic retrograde cholangiopancreatography and intraductal ultrasound confirmed the presence of the lesion. The final histopathological examination showed villous adenoma of the common hepatic duct with high-grade dysplasia. Contrast enhanced ultrasonography used in conjecture with endoscopic retrograde cholangiopancreatography can help in differentiating biliary tumors.

  16. Cavernous hemangioma of the orbit: an unusual acute presentation

    PubMed Central

    Louisraj, Sophia; Ponnudurai, Thendral; Rodriguez, Dominic; Thomas, Philip A; Nelson Jesudasan, Christadoss Arul

    2017-01-01

    We report an unusual presentation of an orbital cavernous hemangioma in a 26-year-old female, who noted sudden redness and swelling of the left eye (LE) on waking up. At presentation, upper eyelid edema with periorbital ecchymosis and subconjunctival hemorrhage were noted in the LE. Although there was transient symptomatic relief with topical medications, blurring of vision developed in the LE. When seen 10 days later, the patient’s LE showed axial proptosis. Magnetic resonance imaging revealed an intraconal soft tissue mass in the superomedial quadrant of the left orbit. Superior orbitotomy with mass excision was done; histopathological examination of the excised mass revealed a cavernous hemangioma. The patient had complete visual recovery following surgery. To our knowledge, an acute presentation of an orbital cavernous hemangioma with subconjunctival hemorrhage and periorbital ecchymosis has not previously been reported. PMID:28769595

  17. Dynamic CT for parathyroid disease: are multiple phases necessary?

    PubMed

    Raghavan, P; Durst, C R; Ornan, D A; Mukherjee, S; Wintermark, M; Patrie, J T; Xin, W; Shada, A L; Hanks, J B; Smith, P W

    2014-10-01

    A 4D CT protocol for detection of parathyroid lesions involves obtaining unenhanced, arterial, early, and delayed venous phase images. The aim of the study was to determine the ideal combination of phases that would minimize radiation dose without sacrificing diagnostic accuracy. With institutional review board approval, the records of 29 patients with primary hyperparathyroidism who had undergone surgical exploration were reviewed. Four neuroradiologists who were blinded to the surgical outcome reviewed the imaging studies in 5 combinations (unenhanced and arterial phase; unenhanced, arterial, and early venous; all 4 phases; arterial alone; arterial and early venous phases) with an interval of at least 7 days between each review. The accuracy of interpretation in lateralizing an abnormality to the side of the neck (right, left, ectopic) and localizing it to a quadrant in the neck (right or left upper, right or left lower) was evaluated. The lateralization and localization accuracy (90.5% and 91.5%, respectively) of the arterial phase alone was comparable with the other combinations of phases. There was no statistically significant difference among the different combinations of phases in their ability to lateralize or localize adenomas to a quadrant (P = .976 and .996, respectively). Assessment of a small group of patients shows that adequate diagnostic accuracy for parathyroid adenoma localization may be achievable by obtaining arterial phase images alone. If this outcome can be validated prospectively in a larger group of patients, then the radiation dose can potentially be reduced to one-fourth of what would otherwise be administered. © 2014 by American Journal of Neuroradiology.

  18. A radar vehicle detection system for four-quadrant gate warning systems and blocked crossing detection.

    DOT National Transportation Integrated Search

    2012-12-01

    The Wavetronix Matrix Radar was adapted for use at four-quadrant gate railroad crossings for the purpose of influencing exit gate behavior upon the detection of vehicles, as an alternative to buried inductive loops. Two radar devices were utilized, o...

  19. Spatial distribution of parasitism on Phyllocnistis citrella Stainton, 1856 (Lepidoptera: Gracillariidae) in citrus orchards.

    PubMed

    Jahnke, S M; Redaelli, L R; Diefenbach, L M G; Efrom, C F

    2008-11-01

    Many species of microhymenopterous parasitoids have been registered on Phyllocnistis citrella, the citrus leafminer. The present study aimed to identify the spatial distribution pattern of the native and introduced parasitoids of P. citrella in two citrus orchards in Montenegro, RS. The new shoots from 24 randomly selected trees in each orchard were inspected at the bottom (0-1.5 m) and top (1.5-2.5 m) stratum and had their position relative to the quadrants (North, South, East and West) registered at every 15 days from July/2002 to June/2003. The leaves with pupae were collected and kept isolated until the emergence of parasitoids or of the leaf miner; so, the sampling was biased towards parasitoids that emerge in the host pupal phase. The horizontal spatial distribution was evaluated testing the fitness of data to the Poisson and negative binomial distributions. In Montenegrina, there was no significant difference in the number of parasitoids and in the mean number of pupae found in the top and bottom strata (chi2 = 0.66; df = 1; P > 0.05) (chi2 = 0.27; df =1; P > 0.05), respectively. In relation to the quadrants, the highest average numbers of the leafminer pupae and of parasitoids were registered at the East quadrant (chi2 = 11.81; df = 3; P < 0.05), (chi2 = 10.36; df = 3; P < 0.05). In the Murcott orchard, a higher number of parasitoids was found at the top stratum (63.5%) (chi2 = 7.24; df =1 P < 0.05), the same occurring with the average number of P. citrella pupae (62.9%) (chi2 = 6.66; df = 1; P < 0.05). The highest number of parasitoids and of miners was registered at the North quadrant (chi2 = 19. 29; df = 3; P < 0.05), (chi2 = 4.39; df = 3; P < 0.05). In both orchards, there was no difference between the numbers of shoots either relative to the strata as well as to the quadrants. As the number of shoots did not varied much relative to the quadrants, it is possible that the higher number of miners and parasitoids in the East and West quadrants would be influenced by the higher solar exposure of these quadrants. The data of the horizontal spatial distribution of the parasitism fit to the negative binomial distribution in all sampling occasions, indicating an aggregated pattern.

  20. MERCURY DEPOSITION AND WATER QUALITY IN THE UPPER MIDWEST, USA

    EPA Science Inventory

    Total wet mercury deposition was monitored weekly at six Upper-Midwest, USA sites for a period of six years, 1990-195, to assess temporal and spatial patterns, and contributions to surface waters. Annual wet mercury deposition averaged 7.4 g Hg/m2yr., showed significant variation...

  1. MERCURY DEPOSITIOIN AND WATER QUALITY TRENDS IN THE UPPER MIDWEST, USA

    EPA Science Inventory

    Total wet mercur deposition was monitored weekly at six Upper-Midwest USA sites for a period of six years, 1990-95, to assess temporal and spatial pattern, and contributions to surface waters. Annual wet mercury deposition averaged 7.4 g Hg/m2yr., showed significant variations b...

  2. Region-based multi-step optic disk and cup segmentation from color fundus image

    NASA Astrophysics Data System (ADS)

    Xiao, Di; Lock, Jane; Manresa, Javier Moreno; Vignarajan, Janardhan; Tay-Kearney, Mei-Ling; Kanagasingam, Yogesan

    2013-02-01

    Retinal optic cup-disk-ratio (CDR) is a one of important indicators of glaucomatous neuropathy. In this paper, we propose a novel multi-step 4-quadrant thresholding method for optic disk segmentation and a multi-step temporal-nasal segmenting method for optic cup segmentation based on blood vessel inpainted HSL lightness images and green images. The performance of the proposed methods was evaluated on a group of color fundus images and compared with the manual outlining results from two experts. Dice scores of detected disk and cup regions between the auto and manual results were computed and compared. Vertical CDRs were also compared among the three results. The preliminary experiment has demonstrated the robustness of the method for automatic optic disk and cup segmentation and its potential value for clinical application.

  3. Cultural-Historical Activity Theory/Design-Based Research in Pasteur's Quadrant

    ERIC Educational Resources Information Center

    Greeno, James G.

    2016-01-01

    About two decades ago, Donald Stokes published "Pasteur's Quadrant" (Stokes, 1997). Stokes proposed that the motivations of different research projects can be understood as a two-dimensional system, with higher or lower concern for improving technology and practice on one dimension and higher or lower concern for improving fundamental…

  4. 49 CFR 230.89 - Reverse gear.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Reverse gear. 230.89 Section 230.89 Transportation... Reversing Gear § 230.89 Reverse gear. (a) General provisions. Reverse gear, reverse levers, and quadrants... quadrant. Proper counterbalance shall be provided for the valve gear. (b) Air-operated power reverse gear...

  5. The mesoscale forcing of a midlatitude upper-tropospheric jet streak by a simulated convective system. 1: Mass circulation and ageostrophic processes

    NASA Technical Reports Server (NTRS)

    Wolf, Bart J.; Johnson, D. R.

    1995-01-01

    The mutual forcing of a midlatitude upper-tropospheric jet streak by organized mesoscale adiabatic and diabatic processes within a simulated convective system (SCS) is investigated. Using isentropic diagnostics, results from a three-dimensional numerical simulation of an SCS are examined to study the isallobaric flow field, modes of dominant ageostrophic motion, and stability changes in relation to the mutual interdependence of adiabatic processes and latent heat release. Isentropic analysis affords an explicit isolation of a component of isallobaric flow associated with diabatic processes within the SCS. Prior to convective development within the simulations, atmospheric destabilization occurs through adiabatic ageostrophic mass adjustment and low-level convergence in association with the preexisting synoptic-scale upper-tropospheric jet streak. The SCS develops in a baroclinic zone and quickly initiates a vigorous mass circulation. By the mature stage, a pronounced vertical couplet of low-level convergence and upper-level mass divergence is established, linked by intense midtropospoheric diabatic heating. Significant divergence persists aloft for several hours subsequent to SCS decay. The dominant role of ageostrophic motion within which the low-level mass convergence develops is the adiabatic isallobaric component, while the mass divergence aloft develops principally through the diabatic isallobaric component. Both compnents are intrinsically linked to the convectively forced vertical mass transport. The inertial diabatic ageostrophic component is largest near the level of maximum heating and is responsible for the development of inertial instability to the north of SCS, resulting in this quadrant being preferred for outflow. The inertial advective component, the dominant term that produces the new downstream wind maximum, rapidly develops north of the SCS and through mutual adjustment creates the baroclinic support for the new jet streak.

  6. Individual A-Scan Signal Normalization Between Two Spectral Domain Optical Coherence Tomography Devices

    PubMed Central

    Chen, Chieh-Li; Ishikawa, Hiroshi; Wollstein, Gadi; Ling, Yun; Bilonick, Richard A.; Kagemann, Larry; Sigal, Ian A.; Schuman, Joel S.

    2013-01-01

    Purpose. We developed a method to normalize optical coherence tomography (OCT) signal profiles from two spectral-domain (SD) OCT devices so that the comparability between devices increases. Methods. We scanned 21 eyes from 14 healthy and 7 glaucoma subjects with two SD-OCT devices on the same day, with equivalent cube scan patterns centered on the fovea (Cirrus HD-OCT and RTVue). Foveola positions were selected manually and used as the center for registration of the corresponding images. A-scan signals were sampled 1.8 mm from the foveola in the temporal, superior, nasal, and inferior quadrants. After oversampling and rescaling RTVue data along the Z-axis to match the corresponding Cirrus data format, speckle noise reduction and amplitude normalization were applied. For comparison between normalized A-scan profiles, mean absolute difference in amplitude in percentage was measured at each sampling point. As a reference, the mean absolute difference between two Cirrus scans on the same eye also was measured. Results. The mean residual of the A-scan profile amplitude was reduced significantly after signal normalization (12.7% vs. 6.2%, P < 0.0001, paired t-test). All four quadrants also showed statistically significant reduction (all P < 0.0001). Mean absolute difference after normalization was smaller than the one between two Cirrus scans. No performance difference was detected between health and glaucomatous eyes. Conclusions. The reported signal normalization method successfully reduced the A-scan profile differences between two SD-OCT devices. This signal normalization processing may improve the direct comparability of OCT image analysis and measurement on various devices. PMID:23611992

  7. Autosomal recessive retinitis pigmentosa caused by mutations in the MAK gene.

    PubMed

    Stone, Edwin M; Luo, Xunda; Héon, Elise; Lam, Byron L; Weleber, Richard G; Halder, Jennifer A; Affatigato, Louisa M; Goldberg, Jacqueline B; Sumaroka, Alexander; Schwartz, Sharon B; Cideciyan, Artur V; Jacobson, Samuel G

    2011-12-28

    To determine the disease expression in autosomal recessive (ar) retinitis pigmentosa (RP) caused by mutations in the MAK (male germ cell-associated kinase) gene. Patients with RP and MAK gene mutations (n = 24; age, 32-77 years at first visit) were studied by ocular examination, perimetry, and optical coherence tomography (OCT). All but one MAK patient were homozygous for an identical truncating mutation in exon 9 and had Ashkenazi Jewish heritage. The carrier frequency of this mutation among 1207 unrelated Ashkenazi control subjects was 1 in 55, making it the most common cause of heritable retinal disease in this population and MAK-associated RP the sixth most common Mendelian disease overall in this group. Visual acuities could be normal into the eighth decade of life. Kinetic fields showed early loss in the superior-temporal quadrant. With more advanced disease, superior and midperipheral function was lost, but the nasal field remained. Only a central island was present at late stages. Pigmentary retinopathy was less prominent in the superior nasal quadrant. Rod-mediated vision was abnormal but detectable in the residual field; all patients had rod>cone dysfunction. Photoreceptor layer thickness was normal centrally but decreased with eccentricity. At the stages studied, there was no evidence of photoreceptor ciliary elongation. The patterns of disease expression in the MAK form of arRP showed some resemblance to patterns described in autosomal dominant RP, especially the form caused by RP1 mutations. The similarity in phenotypes is of interest, considering that there is experimental evidence of interaction between Mak and RP1 in the photoreceptor cilium.

  8. Variations in retinal nerve fiber layer measurements on optical coherence tomography after implantation of trifocal intraocular lens.

    PubMed

    García-Bella, Javier; Martínez de la Casa, José M; Talavero González, Paula; Fernández-Vigo, José I; Valcarce Rial, Laura; García-Feijóo, Julián

    2018-01-01

    To establish the changes produced after implantation of a trifocal intraocular lens (IOL) on retinal nerve fiber layer measurements performed with Fourier-domain optical coherence tomography (OCT). This prospective study included 100 eyes of 50 patients with bilateral cataract in surgical range, no other associated ocular involvement, refractive errors between +5 and -5 spherical diopters, and less than 1.5 D of corneal astigmatism. The eyes were operated by phacoemulsification with implantation of 2 different trifocal IOLs (FineVision and AT LISA tri 839MP) in randomized equal groups. Cirrus OCT and Spectralis OCT were performed before surgery and 3 months later. Both analyzed the thickness of the nerve fiber layer and thickness divided by quadrants (6 in case of Spectralis and 4 in case of Cirrus HD). The mean age of patients was 67.5 ± 5.8 years. The global nerve fiber layer thickness measured with Spectralis OCT was 96.77 μm before surgery and 99.55 μm after. With Cirrus OCT, the global thickness was 85.29 μm before surgery and 89.77 μm after. Statistically significant differences in global thickness measurements between preimplantation and postimplantation of the IOL were found with both OCT in the 2 groups. Statistically significant differences were also found in temporal and superior quadrants. The implantation of a diffractive trifocal IOL alters the results of the optic nerve fiber layer on Fourier-domain OCT in these patients, which should be taken into account in the posterior study of these patients.

  9. Are temporal characteristics of fast repetitive oscillating movement invariant?

    PubMed

    Gutnik, B J; Nicholson, J; Go, W; Gale, D; Nash, D

    2003-06-01

    Validation of the proportional duration model was attempted using very fast single-joint repetitive horizontal abductive-adductive movements of the stretched upper extremity with minimal cognitive input. Participants drew oscillating horizontal lines during 20 sec. over relatively short distances as quickly as possible without visual feedback. Spatial, temporal, and kinetic parameters were analysed. The amplitude and the time spent accelerating, decelerating, and reversing in both directions of each experimental line were recorded and related to the centre of gravity of the upper extremity. The accelerations of the centre of mass of the upper extremity were calculated and used to calculate the forces involved. The ratios of durations were compared and intercorrelated for the two fastest, two average, and two slowest cycles from each participant. Results exhibited significant standard deviations and variability of temporal and kinetic parameters within individual trials. The number of significant coefficients of correlation within individual trials was small despite the controlling influence of the same generalised motor program. The proportional duration model did not hold for our data. Peripheral factors (probably the length-tension relationship rule for skeletal muscles and viscosity of muscle) may be important in this type of action.

  10. Chairside multi-unit restoration of a quadrant using the new Cerec 3D software.

    PubMed

    Ender, A; Wiedhahn, K; Mörmann, W H

    2003-01-01

    The new Cerec 3D design software for inlays and partial and full crowns simplifies work when producing several restorations in one session. Quite significant progress has been achieved, in that the entire row of teeth of a quadrant can be acquired completely and displayed by successively overlapping optical impressions. The digital working model of a quadrant in which all preparations are acquired is the result. The restorations can be designed individually and inserted virtually. Thanks to virtual insertion, the proximal contacts to neighboring restorations can be designed perfectly and all restorations finally designed, milled, and inserted in one sitting. This method provides a significant rationalization effect.

  11. The "four quadrants" approach to clinical ethics case analysis; an application and review.

    PubMed

    Sokol, D K

    2008-07-01

    In 1982, Jonsen, Siegler and Winslade published Clinical Ethics, in which they described the "four quadrants" approach, a new method of analysing clinical ethics cases. Although the book is now in its 6th edition, a literature search has revealed only one academic paper demonstrating the method at work. This paper is an attempt to start filling this gap. As a way of describing and testing the approach, I apply the four quadrants method to a detailed clinical ethics case. The analysis is interspersed with reflections on the method itself. It is hoped that this experiment will encourage ethicists and clinicians to devote more attention to this neglected approach.

  12. Milky Way Kinematics. II. A Uniform Inner Galaxy H I Terminal Velocity Curve

    NASA Astrophysics Data System (ADS)

    McClure-Griffiths, N. M.; Dickey, John M.

    2016-11-01

    Using atomic hydrogen (H I) data from the VLA Galactic Plane Survey, we measure the H I terminal velocity as a function of longitude for the first quadrant of the Milky Way. We use these data, together with our previous work on the fourth Galactic quadrant, to produce a densely sampled, uniformly measured, rotation curve of the northern and southern Milky Way between 3 {kpc}\\lt R\\lt 8 {kpc}. We determine a new joint rotation curve fit for the first and fourth quadrants, which is consistent with the fit we published in McClure-Griffiths & Dickey and can be used for estimating kinematic distances interior to the solar circle. Structure in the rotation curves is now exquisitely well defined, showing significant velocity structure on lengths of ˜200 pc, which is much greater than the spatial resolution of the rotation curve. Furthermore, the shape of the rotation curves for the first and fourth quadrants, even after subtraction of a circular rotation fit shows a surprising degree of correlation with a roughly sinusoidal pattern between 4.2\\lt R\\lt 7 kpc.

  13. Mapping the global football field: a sociological model of transnational forces within the world game.

    PubMed

    Giulianotti, Richard; Robertson, Roland

    2012-06-01

    This paper provides a sociological model of the key transnational political and economic forces that are shaping the 'global football field'. The model draws upon, and significantly extends, the theory of the 'global field' developed previously by Robertson. The model features four quadrants, each of which contains a dominant operating principle, an 'elemental reference point', and an 'elemental theme'. The quadrants contain, first, neo-liberalism, associated with the individual and elite football clubs; second, neo-mercantilism, associated with nation-states and national football systems; third, international relations, associated with international governing bodies; and fourth, global civil society, associated with diverse institutions that pursue human development and/or social justice. We examine some of the interactions and tensions between the major institutional and ideological forces across the four quadrants. We conclude by examining how the weakest quadrant, featuring global civil society, may gain greater prominence within football. In broad terms, we argue that our four-fold model may be utilized to map and to examine other substantive research fields with reference to globalization. © London School of Economics and Political Science 2012.

  14. Investigation of reliability attributes and accelerated stress factors on terrestrial solar cells

    NASA Technical Reports Server (NTRS)

    Lathrop, J. W.; Prince, J. L.

    1980-01-01

    Three tasks were undertaken to investigate reliability attributes of terrestrial solar cells: (1) a study of the electrical behavior of cells in the second (reverse) quadrant; (2) the accelerated stress testing of three new state-of-the-art cells; and (3) the continued bias-temperature testing of four block 2 type silicon cells at 78 C and 135 C. Electrical characteristics measured in the second quadrant were determined to be a function of the cell's thermal behavior with breakdown depending on the initiation of localized heating. This implied that high breakdown cells may be more fault tolerant when forced to operate in the second quadrant, a result contrary to conventional thinking. The accelerated stress tests used in the first (power) quadrant were bias-temperature, bias-temperature-humidity, temperature-humidity, thermal shock, and thermal cycle. The new type cells measured included an EFG cell, a polycrystalline cell, and a Czochralski cell. Significant differences in the response to the various tests were observed between cell types. A microprocessed controlled, short interval solar cell tester was designed and construction initiated on a prototype.

  15. Are Two Systemic Fish Assemblage Sampling Programmes on the Upper Mississippi River Telling Us the Same Thing?

    EPA Science Inventory

    We applied an Index of Biotic Integrity (IBI) used on the Upper Mississippi River (UMR) to compare data from three sampling programs. Ability to use multiple sampling programs could greatly extend spatial and temporal coverage of river assessment and monitoring efforts. We an...

  16. [Clinical and radiographic correlation after anterior cruciate ligament reconstruction].

    PubMed

    González Perales, Aldo Alán; Negrete Corona, Jorge; Chávez Hinojosa, Edgard

    2010-01-01

    The purpose of this work is to correlate the clinical, functional and radiographic results of the anterior cruciate ligament (ACL) reconstruction with the angulation and orientation of the femoral and tibial tunnels. The ACL is one of the most frequently injured articular structures of the knee. The reason for this being that it is the primary limiting structure of anterior tibial translation; its tear causes kinematic alterations and results in long-term degenerative and functional changes. Repair can restore the kinematics. 26 patients, 20-50 years old, post-ACL reconstruction with the semitendinous-gracilis technique. From November 2006 to July 2007. Clinical and functional assessments: Tegner and Lysholm. Radiographic assessment: anteroposterior view with knee extension and lateral view with 30 degrees flexion. Pearson correlations (r) were used in the analysis. 26 patients (100%), 20 males (76.92%), 6 females (23.08%). Mean of 2.4 in the Lysholm scale (fair to good); standard deviation 1.2. Bernard-Lysholm quadrant r = -0.772. Tegner quadrant r = 0.790. The Lysholm and Tegner scale is associated with the graft quadrant. The situation of the tibial implant in the saggital plane is associated with the Lysholm scale. The correlation of patients with an inadequate placement with respect to the quadrants was associated with good-to-excellent results and fair-to-good results. Two patients had a poor clinical outcome; the orientation of the AP angle and the quadrant were within acceptable parameters, with the exception of the lateral angle-shaft axis.

  17. Finding of biliary fascioliasis by endoscopic ultrasonography in a patient with eosinophilic liver abscess.

    PubMed

    Behzad, Catherine; Lahmi, Farhad; Iranshahi, Majid; Mohammad Alizadeh, Amir Houshang

    2014-09-01

    Fascioliasis is an endemic zoonotic disease in Iran. It occurs mainly in sheep-rearing areas of temperate climates, but sporadic cases have been reported from many other parts of the world. The usual definitive host is the sheep. Humans are accidental hosts in the life cycle of Fasciola. Typical symptoms may be associated with fascioliasis, but in some cases diagnosis and treatment may be preceded by a long period of abdominal pain and vague gastrointestinal symptoms. We report a case with epigastric and upper quadrant abdominal pain for the last 6 months, with imaging suggesting liver abscess and normal biliary ducts. The patient had no eosinophilia with negative stool examinations, so she was initially treated with antibiotics for liver abscess. Her clinical condition as well as follow-up imagings showed appropriate response after antibiotic therapy. Finally, endoscopic ultrasonography revealed Fasciola hepatica, which was then extracted with endoscopic retrograde cholangiopancreatography.

  18. Clinical experience with (/sup 111/ In) indium chloride scanning in inflammatory diseases

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

    Dayem, H.M.; Breen, J.; Leslie, E.V.

    1978-05-01

    Forty-eight patients were scanned with /sup 111/In-chloride in an attempt to identify the cause of fever. Fifteen true positive scans, 30 true negatives, and 3 false negatives were found. Of the 15 true positives, 7 cases of abdominal or pelvic abscess, and 8 cases of alcoholic hepatitis were detected. The 3 false negatives included: (1) an abscess in the anterior abdominal wall; (2) an abscess in the right upper quadrant at the site of a necrotic gallbladder; and (3) a tuberculous abscess of the lumbar spine. Examples from the different categories, pitfalls in interpretation and advantages and disadvantages of scanningmore » with /sup 111/In-chloride will be presented. These studies indicate that /sup 111/In-chloride is a safe, reliable scanning agent for abscesses below the diaphragm especially in patients who cannot undergo adequate bowel preparation.« less

  19. Houston/Galveston, Texas, USA

    NASA Image and Video Library

    1991-05-06

    STS039-85-036 (28 April-6 May 1991) --- An orbital pass took the Space Shuttle Discovery over the Houston area, allowing this nearly vertical 70mm photograph to be taken. The north - south bounds extend from a line just north of the Intercontinental Airport at the top of the photo. (Some printings have index numbers near south in the frame). The east - west coverage extends from a line several miles outside the Sam Houston belt system left and right. Parts of the belt system, especially in the south, are still under construction. The Harris County Domed Stadium can be delineated just left of center, and the central business district of Houston is just above center. The work and living areas of the seven astronaut crew members are in the lower right quadrant, including Clear Lake, Taylor Lake, the NASA complex and parts of upper Galveston Bay. Many passes over the Houston area do not exist with the minimal cloud cover seen here.

  20. Laparoscopic cholecystectomy for a left-sided gallbladder.

    PubMed

    Iskandar, Mazen E; Radzio, Agnes; Krikhely, Merab; Leitman, I Michael

    2013-09-21

    Cholecystectomy is a common procedure. Abnormalities in the anatomy of the biliary system are common but an abnormal location of the gallbladder is much rarer. Despite frequent pre-operative imaging, the aberrant location of the gallbladder is commonly discovered at surgery. This article presents a case of a patient with the gallbladder located to the left of the falciform ligament in the absence of situs inversus totalis that presented with right upper quadrant pain. A laparoscopic cholecystectomy was performed and it was noted that the cystic duct originated from the right side. The presence of a left sided gall bladder is often associated with various biliary, portal venous and other anomalies that might lead to intra-operative injuries. The spectrum of unusual positions and anatomical gallbladder abnormalities is reviewed in order to facilitate elective and emergent cholecystectomy as well as other hepatobiliary procedures. With proper identification of the anatomy, minimally invasive approaches are still considered safe.

  1. Laparoscopic cholecystectomy for a left-sided gallbladder

    PubMed Central

    Iskandar, Mazen E; Radzio, Agnes; Krikhely, Merab; Leitman, I Michael

    2013-01-01

    Cholecystectomy is a common procedure. Abnormalities in the anatomy of the biliary system are common but an abnormal location of the gallbladder is much rarer. Despite frequent pre-operative imaging, the aberrant location of the gallbladder is commonly discovered at surgery. This article presents a case of a patient with the gallbladder located to the left of the falciform ligament in the absence of situs inversus totalis that presented with right upper quadrant pain. A laparoscopic cholecystectomy was performed and it was noted that the cystic duct originated from the right side. The presence of a left sided gall bladder is often associated with various biliary, portal venous and other anomalies that might lead to intra-operative injuries. The spectrum of unusual positions and anatomical gallbladder abnormalities is reviewed in order to facilitate elective and emergent cholecystectomy as well as other hepatobiliary procedures. With proper identification of the anatomy, minimally invasive approaches are still considered safe. PMID:24124340

  2. IAE - Inflatable Antenna Experiment

    NASA Image and Video Library

    1996-05-20

    STS077-150-129 (20 May 1996) --- Following its deployment from the Space Shuttle Endeavour, the Spartan 207/Inflatable Antenna Experiment (IAE) payload is backdropped over the Atlantic Ocean and Hampton Roads, Virginia. (Hold photograph vertically with land mass at top.) Virginia Beach and part of Newport News can be delineated in the upper left quadrant of the frame. The view was photographed with a large format still camera on the first full day of in-space operations by the six-member crew. Managed by Goddard Space Flight Center (GSFC), Spartan is designed to provide short-duration, free-flight opportunities for a variety of scientific studies. The Spartan configuration on this flight is unique in that the IAE is part of an additional separate unit which is ejected once the experiment is completed. The IAE experiment will lay the groundwork for future technology development in inflatable space structures, which will be launched and then inflated like a balloon on-orbit.

  3. Using hybrid magnetic bearings to completely suspend the impeller of a ventricular assist device.

    PubMed

    Khanwilkar, P; Olsen, D; Bearnson, G; Allaire, P; Maslen, E; Flack, R; Long, J

    1996-06-01

    Clinically available blood pumps and those under development suffer from poor mechanical reliability and poor biocompatibility related to anatomic fit, hemolysis, and thrombosis. To alleviate these problems concurrently in a long-term device is a substantial challenge. Based on testing the performance of a prototype, and on our judgment of desired characteristics, we have configured an innovative ventricular assist device, the CFVAD4, for long-term use. The design process and its outcome, the CFVAD4 system configuration, is described. To provide unprecedented reliability and biocompatibility, magnetic bearings completely suspend the rotating pump impeller. The CFVAD4 uses a combination of passive (permanent) and active (electric) magnetic bearings, a mixed flow impeller, and a slotless 3-phase brushless DC motor. These components are shaped, oriented, and integrated to provide a compact, implantable, pancake-shaped unit for placement in the left upper abdominal quadrant of adult humans.

  4. Splenic infarction associated with sickle cell trait at low altitude.

    PubMed

    Seegars, Mary Beth; Brett, Allan S

    2015-12-01

    Sickle cell trait is widely known to be associated with splenic infarction at high altitudes. Although textbooks and reviews imply that this complication does not occur at low altitudes, we encountered such a case and identified several previous cases in the literature. An 18-year-old woman with sickle cell trait who resided near sea level presented with left upper quadrant abdominal pain and was found to have multiple splenic infarcts. She was otherwise well, with no comorbidities that would predispose to hypoxemia or vascular injury. A review of the literature revealed 12 previously published cases of low-altitude splenic infarction in patients with sickle trait; 7 of those patients had comorbidities that likely predisposed to splenic infarction. None. Spontaneous splenic infarction can occur in patients with sickle trait who live at low altitudes. It is unclear whether this complication is rare, or whether it is relatively common but under-recognized.

  5. Bacteroides (Parabacteroides) distasonis splenic abscess in a sickle cell patient.

    PubMed

    Al-Tawfiq, Jaffar A

    2008-01-01

    Splenic abscess is not an uncommon complication of patients with sickle-cell disease. Here we describe an 18 year-old boy with sickle cell disease and left upper quadrant abdominal pain. Computerized axial tomography revealed left sided free flowing pleural effusion and splenomegaly with liquefaction and possible gas formation. The splenic fluid grew an unusual organism known as Bacteroides distasonis. The patient received antimicrobial therapy and underwent a splenectomy with full recovery. The spleen was cystically infarcted and measured 22 x 16 x 5 cm. The capsule was thickened and covered by fibrinous exudate. Histopathologic examination of the spleen showed complete necrosis with reparative fibrosis. This case presents an unusual cause of splenic abscess due to Bacteroides distasonis with a subacute to chronic course. The presence of fever and left sided pleuritic chest pain in patients with sickle cell disease should raise the suspicion of splenic abscess.

  6. The Splenic Syndrome in Individuals with Sickle Cell Trait

    PubMed Central

    Hassell, Kathryn; Irwin, David; Witkowski, Ewa H.; Nuss, Rachelle

    2014-01-01

    Abstract Goodman, Jessica, Kathryn Hassell, David Irwin, Ewa H. Witkowski, and Rachelle Nuss. The splenic syndrome in individuals with sickle cell trait. High Alt Med Biol 15:468–471, 2014.—The medical records of 25 individuals with sickle cell trait and altitude-associated splenic infarct, reported to two Colorado physicians, were reviewed. Electrospray mass spectroscopy was performed on blood samples from a cohort of 10 of the individuals to rapidly confirm beta hemoglobin phenotype. Only males were identified with a 1.4:1 ratio of non-African Americans to African Americans, and 44% of African Americans and 85% of non-African Americans were unaware they had sickle cell trait. Left upper quadrant pain and an elevated bilirubin were nearly uniformly present. Either abdominal CT or ultrasound was confirmatory. Conservative treatment at a lower altitude generally resulted in a favorable outcome. PMID:25361178

  7. Multiple inflammatory and serum amyloid A positive telangiectatic hepatic adenomas with glycogenated nuclei arising in a background of nonalcoholic steatohepatitis.

    PubMed

    Lim, Kiat H; Ward, Stephen C; Roayaie, Sasan; Cohen, Emil; Schwartz, Myron; Fiel, M Isabel; Thung, Swan N

    2008-11-01

    The authors describe multiple telangiectatic or inflammatory adenomas in a 53-year-old woman with steatohepatitis who presented with acute right upper quadrant abdominal pain. Magnetic resonance imaging revealed 6 lesions consistent with multiple hepatic adenomas, 2 of which showed hemorrhage. She underwent right lobectomy and nonanatomical segment 2 liver resections and seven nodules ranging in size from 1.0 to 5.0 cm were identified. All nodules contained portal-like structures and ductular reaction, features seen in focal nodular hyperplasia, as well as significant inflammation, telangiectatic sinusoids and immunoreactivity for serum amyloid A, placing them according to a recently described classification systems as telangiectatic or inflammatory adenomas. The diffuse positivity of the serum amyloid A staining results in this case suggests an important diagnostic role of this stain in smaller tissue samples, such as in core biopsy specimens.

  8. Cholestasis caused by Fasciola gigantica.

    PubMed

    Beştaş, Remzi; Yalçin, Kendal; Çiçek, Muttalip

    2014-01-01

    Fascioliasis is an infectious disease caused by the hepatic trematodes Fasciola hepatica and Fasciola gigantica. Here, we report the case of Fasciola gigantica presenting with biliary obstruction and abdominal pain that was diagnosed and treated by endoscopic retrograde cholangiography (ERCP). A 46-year-old woman presented with right upper quadrant abdominal pain and jaundice. Physical examination revealed icterus and hepatomegaly. Laboratory findings revealed an increase in liver transaminases and bilirubin. Abdominal ultrasonography showed extrahepatic and intrahepatic bile duct dilatation. The patient underwent ERCP. One live Fasciola gigantica was removed from the common bile duct by ERCP. In conclusion, fascioliasis should be considered in the differential diagnosis of obstructive jaundice, especially in endemic regions, and it should be kept in mind that ERCP plays an important role in the diagnosis and treatment of these patients. To our knowledge, this is the second case report of Fasciola gigantica treated by ERCP in Turkey.

  9. Spontaneous Intrahepatic Type II Gallbladder Perforation: A Rare Cause of Liver Abscess – Case Report

    PubMed Central

    Singh, Kumkum; Singh, Amit; Vidyarthi, Shivaji H; Jindal, Satyaprakash; Thounaojam, Chandra Kumar

    2013-01-01

    A liver abscess formation is a rare complication of a gallbladder perforation, with a cholecystohepatic communication. Niemeier, in 1934, classified free gallbladder perforations and generalised biliary peritonitis as an acute or a Type I gallbladder perforation, a pericholecystic abscess and localised peritonitis as a subacute or a Type II gallbladder perforation, and cholecystoenteric fistulas as chronic or Type III gallbladder perforations. We are describing a 50–year–old male patient who presented with right upper quadrant pain and was found to have an intrahepatic perforation of the gallbladder. Our patient had a Type II perforation. We have discussed the diagnostic work-up and the management of this rare entity. Due to the high mortality that can be caused by a delay in making the correct diagnosis, a gallbladder perforation represents a special diagnostic and surgical challenge. PMID:24179927

  10. Natural history, clinicoradiologic correlates, and response to triclabendazole in acute massive fascioliasis.

    PubMed

    Marcos, Luis A; Tagle, Martin; Terashima, Angelica; Bussalleu, Alejandro; Ramirez, Cesar; Carrasco, Carlos; Valdez, Luis; Huerta-Mercado, Jorge; Freedman, David O; Vinetz, Joseph M; Gotuzzo, Eduardo

    2008-02-01

    Fascioliasis is highly endemic in the Andean region of South America. Newer serological assays have improved our ability to diagnose acute fascioliasis. The diagnosis was established by Fasciola hepatica serology (Fas2-ELISA or Western blot) in 10 patients. Identifiable exposure included ingestion of watercress (N = 8), alfalfa juice (N = 5), and lettuce (N = 1). Computed tomography of the abdomen showed hepatomegaly (N = 9), track-like hypodense lesions with subcapsular location (N = 8), and subcapsular hematoma (N = 2). Radiologic sequelae included cyst calcifications detectable at least 3 years after treatment. Stool examinations were negative for F. hepatica eggs; serology was positive (Arc II [N = 2], Fas2-ELISA [N = 6], Western blot [N = 2]). The syndrome of eosinophilia, fever, and right upper quadrant pain, elevated transaminases without jaundice, hypodense liver lesions on CT, and an appropriate exposure history suggests acute fascioliasis. Fascioliasis is specifically treatable with a single dose of triclabendazole.

  11. Laparoscopic excision of an epidermoid cyst arising from the deep abdominal wall.

    PubMed

    Ishikawa, Hajime; Nakai, Takuya; Ueda, Kazuki; Haji, Seiji; Takeyama, Yoshifumi; Ohyanagi, Harumasa

    2009-10-01

    Epidermoid cysts are the most common type of cutaneous cyst. However, their occurrence in the deep abdominal wall has not yet been reported. Here, we present the case of a 60-year-old woman who developed an epidermoid cyst in the deep abdominal wall, which was resected laparoscopically. The patient presented with right upper quadrant abdominal pain on admission to our hospital. Computed tomography revealed cholecystolithiasis and an incidentally identified well-defined hypoattenuating mass (62 x 47 x 65 mm) in the deep abdominal wall on the left side of the navel. We performed laparoscopic complete resection of the abdominal wall tumor followed by cholecystectomy. The excised specimen was a cyst covered with a smooth thin membrane and contained sludge. Histopathologic examination revealed an epidermoid cyst. This is a very rare case with no previous reports on a similar type of epidermoid cyst.

  12. Fulminant hepatic failure due to metastatic choroidal melanoma

    PubMed Central

    Escobar-Valdivia, Emmanuel; Monreal-Robles, Roberto; Delgado-García, Guillermo; Hernández-Velazquez, Badir

    2017-01-01

    Background: Acute liver failure (ALF) as a consequence of metastatic disease is extremely uncommon. The liver is the most commonly affected organ by metastatic disease, but only a few cases of ALF in the setting of metastatic choroidal melanoma have been reported. Case Presentation: We describe the case of a 47-year-old man with right upper quadrant pain, progressive jaundice, and unintentional weight loss. He also reported that he had experienced reduced left visual acuity which progressed to blindness over 2 months. On physical examination, we found a pigmented scleral lesion in the left eye. He had a coagulopathy and, during his hospital stay, he also developed encephalopathy. The diagnosis of ALF was therefore established and was later attributed to metastatic uveal melanoma. In addition, we briefly review the relevant literature. Conclusion: Liver metastasis should be kept in mind when assessing abnormal liver function tests in patients with uveal malignant melanoma. PMID:28503286

  13. Predictive Value of Primary Tumor Site for Loco-regional Recurrence in Early Breast Cancer Patients with One to Three Positive Axillary Lymphadenophy.

    PubMed

    Niu, Shaoqing; Wen, Ge; Ren, Yufeng; Li, Yiyang; Feng, Lingling; Wang, Chengtao; Huang, Xiaobo; Wen, Bixiu; Zhang, Yujing

    2017-01-01

    Introduction: It remains controversial on high risks for early breast cancer patients with one to three axillary nodes after mastectomy who is predisposition to locoregional recurrence. The present study is to investigate the relationship between primary tumor site and loco-regional recurrence (LRR) and explore the predictive value of clinicopathological characteristics in LRR for early breast cancer patients with one to three positive axillary lymph nodes after mastectomy. Methods: We reviewed the clinical data of 656 consecutively diagnosed patients with pT 1-2 N 1 M 0 breast cancer who were treated in Sun Yat-sen University Cancer Center with radical operation without postoperative radiotherapy between March 1998 and December 2010. The primary tumor sites included outer quadrant in 455 patients (69.36%), inner quadrant in 156 patients (23.78%)and central quadrant in 45 patients (6.86%). LRR and LRR-free survival (LRFS) in combination with clinical and pathological features were analyzed to screen out patients with higher risk of LRR. Results: The median follow-up time was 64.9 months. The 5-, 10-year LRR for the cohort was 8.6% and 12.9%, respectively; the 5-, 10-year LRFS was 86.2% and 76.4%, respectively. Multivariate analyses showed that age of ≤35 years, inner quadrant tumor and non-luminal subtype were independent risk factors for LRR and LRFS. Patients with primary tumor in inner quadrant showed higher LRR and poorer LRFS when risk factors are ≥2 than those with tumors in other sites. Conclusions: Inner quadrant tumor was an independent predictor for LRR and LRFS in patients with early breast cancer and one to three positive axillary lymph nodes, which would be more accurate in combination with other prognostic indexes including patients' age, pathological T stage, Ki67 status, molecular subtypes.

  14. Effects of Age, Gender, Bolus Condition, Viscosity, and Volume on Pharyngeal and Upper Esophageal Sphincter Pressure and Temporal Measurements during Swallowing

    ERIC Educational Resources Information Center

    Butler, Susan G.; Stuart, Andrew; Castell, Donald; Russell, Gregory B.; Koch, Kenneth; Kemp, Shannon

    2009-01-01

    Purpose: The purpose of this study was to determine the effects of trial (i.e., Trial 1 vs. Trial 2); viscosity (i.e., saliva, thin, nectar-thick, honey-thick, and pudding-thick water); volume (i.e., 5 mL vs. 10 mL); age (i.e., young vs. older adults); and gender on pharyngeal (i.e., upper and lower) and upper esophageal sphincter (UES) pressures,…

  15. Examining Sensory Quadrants in Autism

    ERIC Educational Resources Information Center

    Kern, Janet K.; Garver, Carolyn R.; Carmody, Thomas; Andrews, Alonzo A.; Trivedi, Madhukar H.; Mehta, Jyutika A.

    2007-01-01

    The purpose of this study was to examine sensory quadrants in autism based on Dunn's Theory of Sensory Processing. The data for this study was collected as part of a cross-sectional study that examined sensory processing (using the Sensory Profile) in 103 persons with autism, 3-43 years of age, compared to 103 age- and gender-matched community…

  16. Status of Reconstruction of Fragmented Diamond-on-Silicon Collector From Genesis Spacecraft Solar Wind Concentrator

    NASA Technical Reports Server (NTRS)

    Rodriquez, Melissa C.; Calaway, M. C.; McNamara, K. M.; Hittle, J. D.

    2009-01-01

    In addition to passive solar wind collector surfaces, the Genesis Discovery Mission science canister had on board an electrostatic concave mirror for concentrating the solar wind ions, known as the concentrator . The 30-mm-radius collector focal point (the target) was comprised of 4 quadrants: two of single crystal SiC, one of polycrystalline 13C diamond and one of diamond-like-carbon (DLC) on a silicon substrate. [DLC-on-silicon is also sometimes referenced as Diamond-on-silicon, DOS.] Three of target quadrants survived the hard landing intact, but the DLC-on-silicon quadrant fractured into numerous pieces (Fig. 1). This abstract reports the status of identifying the DLC target fragments and reconstructing their original orientation.

  17. Retinal nerve fiber layer thickness analysis in suspected malingerers with optic disc temporal pallor

    PubMed Central

    Civelekler, Mustafa; Halili, Ismail; Gundogan, Faith C; Sobaci, Gungor

    2009-01-01

    Purpose: To investigate the value of temporal retinal nerve fiber layer (RNFLtemporal) thickness in the prediction of malingering. Materials and Methods: This prospective, cross-sectional study was conducted on 33 military conscripts with optic disc temporal pallor (ODTP) and 33 age-and sex-matched healthy controls. Initial visual acuity (VAi) and visual acuity after simulation examination techniques (VAaset) were assessed. The subjects whose VAaset were two or more lines higher than VAi were determined as malingerers. Thickness of the peripapillary RNFL was determined with OCT (Stratus OCT™, Carl Zeiss Meditec, Inc.). RNFLtemporal thickness of the subjects were categorized into one of the 1+ to 4+ groups according to 50% confidence interval (CI), 25% CI and 5% CI values which were assessed in the control group. The VAs were converted to LogMAR-VAs for statistical comparisons. Results: A significant difference was found only in the temporal quadrant of RNFL thickness in subjects with ODTP (P=0.002). Mean LogMAR-VA increased significantly after SETs (P<0.001). Sensitivity, specificity, positive and negative predictive values of categorized RNFLtemporal thickness in diagnosing malingering were 84.6%, 75.0%, 68.8%, 88.2%, respectively. ROC curve showed that RNFLtemporal thickness of 67.5 μm is a significant cut-off point in determining malingering (P=0.001, area under the curve:0.862). The correlations between LogMAR-VAs and RNFLtemporal thicknesses were significant; the correlation coefficient for LogMAR-VAi was lower than the correlation for LogMAR-VAaset (r=−0.447, P=0.009 for LogMAR-VAi; r=−0.676, P<0.001 for LogMAR-VAaset). Conclusions: RNFLtemporal thickness assessment may be a valuable tool in determining malingering in subjects with ODTP objectively. PMID:19700875

  18. Estimating inter-annual diversity of seasonal agricultural area using multi-temporal resourcesat data.

    PubMed

    Sreenivas, K; Sekhar, N Seshadri; Saxena, Manoj; Paliwal, R; Pathak, S; Porwal, M C; Fyzee, M A; Rao, S V C Kameswara; Wadodkar, M; Anasuya, T; Murthy, M S R; Ravisankar, T; Dadhwal, V K

    2015-09-15

    The present study aims at analysis of spatial and temporal variability in agricultural land cover during 2005-6 and 2011-12 from an ongoing program of annual land use mapping using multidate Advanced Wide Field Sensor (AWiFS) data aboard Resourcesat-1 and 2. About 640-690 multi-temporal AWiFS quadrant data products per year (depending on cloud cover) were co-registered and radiometrically normalized to prepare state (administrative unit) mosaics. An 18-fold classification was adopted in this project. Rule-based techniques along with maximum-likelihood algorithm were employed to deriving land cover information as well as changes within agricultural land cover classes. The agricultural land cover classes include - kharif (June-October), rabi (November-April), zaid (April-June), area sown more than once, fallow lands and plantation crops. Mean kappa accuracy of these estimates varied from 0.87 to 0.96 for various classes. Standard error of estimate has been computed for each class annually and the area estimates were corrected using standard error of estimate. The corrected estimates range between 99 and 116 Mha for kharif and 77-91 Mha for rabi. The kharif, rabi and net sown area were aggregated at 10 km × 10 km grid on annual basis for entire India and CV was computed at each grid cell using temporal spatially-aggregated area as input. This spatial variability of agricultural land cover classes was analyzed across meteorological zones, irrigated command areas and administrative boundaries. The results indicate that out of various states/meteorological zones, Punjab was consistently cropped during kharif as well as rabi seasons. Out of all irrigated commands, Tawa irrigated command was consistently cropped during rabi season. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. EAGLE can do Efficient LTL Monitoring

    NASA Technical Reports Server (NTRS)

    Barringer, Howard; Goldberg, Allen; Havelund, Klaus; Sen, Koushik

    2003-01-01

    We briefly present a rule-based framework, called EAGLE, that has been shown to be capable of defining and implementing finite trace monitoring logics, including future and past time temporal logic, extended regular expressions, real-time logics, interval logics, forms of quantified temporal logics, and so on. In this paper we show how EAGLE can do linear temporal logic (LTL) monitoring in an efficient way. We give an upper bound on the space and time complexity of this monitoring.

  20. Multidisciplinary research in the space sciences

    NASA Technical Reports Server (NTRS)

    Broecker, W. S.; Flynn, G. W.

    1983-01-01

    Research activities were carried out in the following areas during this reporting period: (1) astrophysics; (2) climate and atmospheric modeling; and (3) climate applications of earth observations & geological studies. An ultra-low-noise 115 GHz receiver based upon a superconducting tunnel diode mixer has been designed and constructed. The first laboratory tests have yielded spectacular results: a single-sideband noise temperature of 75 K considerably more sensitive than any other receiver at this frequency. The receiver will replace that currently in use on the Columbia-GISS CO Sky Survey telescope. The 1.2 meter millimeter-wave telescope at Columbia University has been used to complete two large-scale surveys of molecular matter in the part of the inner galaxy which is visible from the Northern hemisphere (the first galactic quadrant); one of the distant galaxy and one of the solar neighborhood. The research conducted during the past year in the climate and atmospheric modeling programs has been focused on the development of appropriate atmospheric and upper ocean models, and preliminary applications of these models. Principal models are a one-dimensional radiative-convective model, a three-dimensional global climate model, and an upper ocean model. During the past year this project has focused on development of 2-channel satellite analysis methods and radiative transfer studies in support of multichannel analysis techniques.

  1. Djibouti, the capital city of the country of Djibouti

    NASA Image and Video Library

    2000-11-20

    ISS001-E-5028 (December 2000) --- Djibouti, the capital city of the country of Djibouti, can be seen in this northeast-looking view taken from the International Space Station (ISS) with a digital still camera using a 400mm lens. Djibouti, scarcely 100 years old, sits on the western shore of an isthmus in the Gulf of Tadjoura, an arm of the Gulf of Aden. Djibouti is surrounded by a rugged and bleak landscape, that has a dry and hot climate. The population of Djibouti has grown from an estimated 96,000 in 1973 to over 330,000 in 1991 mainly due to the influx of refugees from the neighboring, war torn countries of Ethiopia and Somalia. With its strategically located port, Djibouti’s economic importance results from the large transit trade it enjoys as the terminus of a railroad line from Addis Ababa in Ethiopia. The city has seen an increase in tourism in the past decade due a large number of cruise ships visiting the port. Besides tourism, salt production and shipbuilding and repair are other major industries. Below the center of the image, the long runway of the Djibouti/Ambouli International Airport is visible. Coral reefs are discernible in the upper left and upper right quadrants of the image.

  2. Gastric fistula secondary to drainage tube penetration: A report of a rare case.

    PubMed

    Shao, Hui-Jiang; Lu, Bao-Chun; Xu, Huan-Jian; Ruan, Xin-Xian; Yin, Jing-Song; Shen, Zhi-Hong

    2016-03-01

    Cases of gastric fistula secondary to drainage tube penetration have rarely been reported. The current study presents a case of gastric penetration caused by misplacement of a drainage tube after a splenectomy. The patient was admitted to the Department of Hepatobiliary Surgery, (Shaoxing People's Hospital, Shaoxing Hospital of Zhejiang University, Shaoxing, Zhejiang, China) for blunt abdominal trauma due to injuries sustained in an automobile accident. A ruptured spleen was found and successfully removed surgically. On post-operative day 7, the patient complained of slight discomfort and tenderness in the left upper quadrant of the abdomen. In addition, 500 ml of bile-colored fluid with small food particles was noted in the drainage tube. Barium X-ray revealed a gastric fistula in the upper gastrointestinal tract. Gastroscopy indicated infiltration of the drainage tube into the gastric cavity. No significant peritoneal effusion was observed, as revealed by abdominal ultrasound examination. These results confirmed the diagnosis of a gastric fistula secondary to perforation by the drainage tube. Following conservative treatment with antibiotics and total parenteral nutrition, the general condition of the patient improved significantly. The drainage tube was withdrawn progressively, as the amount of fluid being discharged was decreasing. Gastroenterography confirmed perforation closure and the tube was finally removed on post-operative day 44.

  3. Management of ampullary tumours in children: still a challenge.

    PubMed

    Fernandez-Eire, P; Vazquez Castelo, J L; Herreros Villaraviz, M; Fernandez Caamaño, B; Gonzalez-Carreró, J; Ausania, F

    2017-05-01

    This study describes the case of the youngest patient ever reported with ampullary adenoma. The incidence of ampullary adenomas in childhood is unknown. Endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound are used in adults to assess and treat these lesions, although there are no instruments designed specifically for use in young children. A six-year-old girl was admitted for abdominal pain, vomiting, pruritus and weight loss. Abdominal ultrasound showed biliary tree (8mm) and pancreatic duct dilatation (4mm). Magnetic resonance cholangiopancreatography and computed tomography confirmed these findings, and also showed displacement of the ampulla to the left upper quadrant. An upper endoscopy confirmed a large ampullary adenoma. A laparotomy was performed and a 5cm villous tumour arising from the ampulla was excised. The postoperative course was uneventful. The histology demonstrated adenoma of the ampulla (intestinal type) without low-grade dysplasia. all clinical and radiological parameters are normal at 20 months follow-up. We describe the case of the youngest patient ever reported with ampullary adenoma. Pancreaticoduodenectomy carries high morbidity and mortality rates, and therefore it should be avoided in absence of histologically proven malignancy. We believe that surgical ampullectomy is a safe and oncologically correct procedure until better endoscopic instruments for peadiatric use will be designed.

  4. Mapping spatial and temporal variation of stream water temperature in the upper Esopus Creek watershed

    NASA Astrophysics Data System (ADS)

    Chien, H.; McGlinn, L.

    2017-12-01

    The upper Esopus Creek and its tributary streams located in the Catskill Mountain region of New York State provide habitats for cold-adapted aquatic species. However, ongoing global warming may change the stream water temperature within a watershed and disturb the persistence of coldwater habitats. Characterizing thermal regimes within the upper Esopus Creek watershed is important to provide information of thermally suitable habitats for aquatic species. The objectives of this study are to measure stream water temperature and map thermal variability among tributaries to the Esopus Creek and within Esopus Creek. These objectives will be achieved by measuring stream water temperature for at least two years. More than 100 water temperature data loggers have been placed in the upper Esopus Creek and their tributaries to collect 30-minute interval water temperatures. With the measured water temperature, we will use spatial interpolation in ArcGIS to create weekly and monthly water temperature surface maps to evaluate the thermal variation over time and space within the upper Esopus Creek watershed. We will characterize responsiveness of water temperature in tributary streams to air temperature as well. This information of spatial and temporal variation of stream water temperature will assist stream managers with prioritizing management practices that maintain or enhance connectivity of thermally suitable habitats in high priority areas.

  5. Spatial and Temporal Patterns of Nitrification Rates in Forested Floodplain Wetland Soils of Upper Mississippi River Pool 8, Journal Article

    EPA Science Inventory

    Overbank flooding is thought to be a critical process controlling nitrogen retention and cycling. In this study we investigated the effects of season and flood frequency on soil nitrification rates at ten sites in forested floodplains of Upper Mississippi River, Pool 8...A rough ...

  6. Omental infarction: preoperative diagnosis and laparoscopic management in children.

    PubMed

    Gosain, Ankush; Blakely, Martin; Boulden, Thomas; Uffman, John K; Seetharamaiah, Rupa; Huang, Eunice; Langham, Max; Eubanks, James W

    2010-11-01

    Omental infarction (OI) is an unusual, poorly characterized cause of abdominal pain in children and is often mistaken for appendicitis preoperatively. We present our experience with this disease process over a 5-year period to identify preoperative factors to aid in timely diagnosis and treatment. We retrospectively reviewed the medical records of all children that had OI and underwent laparoscopic omentectomy from November 2004 to June 2009. Ten patients with the diagnosis of OI were identified. OI occurred in 9 boys and 1 girl, with a median age at presentation of 8.5 years (range, 7-11). Median body mass index at presentation was 23.7 (range, 17-29), with 1 child categorized as healthy weight for age, 1 child as overweight for age, and 5 children as obese for age, based on Centers for Disease Control and Prevention criteria. All patients complained of right-sided abdominal pain; 4 patients complained of predominantly right-upper quadrant (RUQ) pain, 3 patients of right-lower quadrant (RLQ) pain, and 3 of combined RUQ/RLQ pain. On examination, 6 patients had RUQ tenderness and 4 patients had RLQ tenderness. The median duration of symptoms prior to seeking medical attention was 3 days (range, 2-7). All patients underwent computed tomography and the preoperative diagnosis of OI was established in 9 of 10 cases. Operative time was 48 ± 14 minutes. All patients underwent resection of the infarcted omentum; 2 patients underwent concurrent appendectomy. Median length of stay was 2 days (range, 2-4). OI occurs predominantly, but not exclusively, in obese preadolescent males. OI can be reliably distinguished from appendicitis on preoperative history, physical examination, laboratory analysis, and imaging. Laparoscopic omentectomy results in prompt resolution of symptoms and discharge.

  7. Bacterial microbiota compositions of naturally fermented milk are shaped by both geographic origin and sample type.

    PubMed

    Zhong, Z; Hou, Q; Kwok, L; Yu, Z; Zheng, Y; Sun, Z; Menghe, B; Zhang, H

    2016-10-01

    Naturally fermented dairy products contain a rich microbial biodiversity. This study aimed to provide an overview on the bacterial microbiota biodiversity of 85 samples, previously collected across a wide region of China, Mongolia, and Russia. Data from these 85 samples, including 55 yogurts, 18 naturally fermented yak milks, 6 koumisses, and 6 cheeses, were retrieved and collectively analyzed. The most prevalent phyla shared across samples were Firmicutes, Proteobacteria, Bacteroidetes, and Actinobacteria, which together accounted for 99% of bacterial sequences. The predominant genera were Lactobacillus, Lactococcus, Streptococcus, Acetobacter, Acinetobacter, Leuconostoc, and Macrococcus, which together corresponded to 96.63% of bacterial sequences. Further multivariate statistical analyses revealed significant differences in the microbiota structure across sample geographic origin and type. First, on the principal coordinate score plot, samples representing the 3 main sample collection regions (Russia, Xinjiang, and Tibet) were mostly located respectively in the upper left, lower right, and lower left quadrants, although slight overlapping occurred. In contrast, samples from the minor sampling areas (Inner Mongolia, Mongolia, Gansu, and Sichuan) were predominantly distributed in the lower left quadrant. These results suggest a possible association between sample geographical origin and microbiota composition. Second, bacterial microbiota structure was stratified by sample type. In particular, the microbiota of cheese was largely distinct from the other sample types due to its high abundances of Lactococcus and Streptococcus. The fermented yak milk microbiota was most like that of the yogurts. Koumiss samples had the lowest microbial diversity and richness. In conclusion, both geographic origin and sample type shape the microbial diversity of naturally fermented milk. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

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

    Na, Ji Sung; Koo, Eunmo; Munoz-Esparza, Domingo

    High-resolution large-eddy simulation of the flow over a large wind farm (64 wind turbines) is performed using the HIGRAD/FIRETEC-WindBlade model, which is a high-performance computing wind turbine–atmosphere interaction model that uses the Lagrangian actuator line method to represent rotating turbine blades. These high-resolution large-eddy simulation results are used to parameterize the thrust and power coefficients that contain information about turbine interference effects within the wind farm. Those coefficients are then incorporated into the WRF (Weather Research and Forecasting) model in order to evaluate interference effects in larger-scale models. In the high-resolution WindBlade wind farm simulation, insufficient distance between turbines createsmore » the interference between turbines, including significant vertical variations in momentum and turbulent intensity. The characteristics of the wake are further investigated by analyzing the distribution of the vorticity and turbulent intensity. Quadrant analysis in the turbine and post-turbine areas reveals that the ejection motion induced by the presence of the wind turbines is dominant compared to that in the other quadrants, indicating that the sweep motion is increased at the location where strong wake recovery occurs. Regional-scale WRF simulations reveal that although the turbulent mixing induced by the wind farm is partly diffused to the upper region, there is no significant change in the boundary layer depth. The velocity deficit does not appear to be very sensitive to the local distribution of turbine coefficients. However, differences of about 5% on parameterized turbulent kinetic energy were found depending on the turbine coefficient distribution. Furthermore, turbine coefficients that consider interference in the wind farm should be used in wind farm parameterization for larger-scale models to better describe sub-grid scale turbulent processes.« less

  9. Turbulent kinetics of a large wind farm and their impact in the neutral boundary layer

    DOE PAGES

    Na, Ji Sung; Koo, Eunmo; Munoz-Esparza, Domingo; ...

    2015-12-28

    High-resolution large-eddy simulation of the flow over a large wind farm (64 wind turbines) is performed using the HIGRAD/FIRETEC-WindBlade model, which is a high-performance computing wind turbine–atmosphere interaction model that uses the Lagrangian actuator line method to represent rotating turbine blades. These high-resolution large-eddy simulation results are used to parameterize the thrust and power coefficients that contain information about turbine interference effects within the wind farm. Those coefficients are then incorporated into the WRF (Weather Research and Forecasting) model in order to evaluate interference effects in larger-scale models. In the high-resolution WindBlade wind farm simulation, insufficient distance between turbines createsmore » the interference between turbines, including significant vertical variations in momentum and turbulent intensity. The characteristics of the wake are further investigated by analyzing the distribution of the vorticity and turbulent intensity. Quadrant analysis in the turbine and post-turbine areas reveals that the ejection motion induced by the presence of the wind turbines is dominant compared to that in the other quadrants, indicating that the sweep motion is increased at the location where strong wake recovery occurs. Regional-scale WRF simulations reveal that although the turbulent mixing induced by the wind farm is partly diffused to the upper region, there is no significant change in the boundary layer depth. The velocity deficit does not appear to be very sensitive to the local distribution of turbine coefficients. However, differences of about 5% on parameterized turbulent kinetic energy were found depending on the turbine coefficient distribution. Furthermore, turbine coefficients that consider interference in the wind farm should be used in wind farm parameterization for larger-scale models to better describe sub-grid scale turbulent processes.« less

  10. Aluminium, antiperspirants and breast cancer.

    PubMed

    Darbre, P D

    2005-09-01

    Aluminium salts are used as the active antiperspirant agent in underarm cosmetics, but the effects of widespread, long term and increasing use remain unknown, especially in relation to the breast, which is a local area of application. Clinical studies showing a disproportionately high incidence of breast cancer in the upper outer quadrant of the breast together with reports of genomic instability in outer quadrants of the breast provide supporting evidence for a role for locally applied cosmetic chemicals in the development of breast cancer. Aluminium is known to have a genotoxic profile, capable of causing both DNA alterations and epigenetic effects, and this would be consistent with a potential role in breast cancer if such effects occurred in breast cells. Oestrogen is a well established influence in breast cancer and its action, dependent on intracellular receptors which function as ligand-activated zinc finger transcription factors, suggests one possible point of interference from aluminium. Results reported here demonstrate that aluminium in the form of aluminium chloride or aluminium chlorhydrate can interfere with the function of oestrogen receptors of MCF7 human breast cancer cells both in terms of ligand binding and in terms of oestrogen-regulated reporter gene expression. This adds aluminium to the increasing list of metals capable of interfering with oestrogen action and termed metalloestrogens. Further studies are now needed to identify the molecular basis of this action, the longer term effects of aluminium exposure and whether aluminium can cause aberrations to other signalling pathways in breast cells. Given the wide exposure of the human population to antiperspirants, it will be important to establish dermal absorption in the local area of the breast and whether long term low level absorption could play a role in the increasing incidence of breast cancer.

  11. Effect of Intraoral Aging on Debris Accumulation and Friction of First Molar Tubes.

    PubMed

    Chaptini, Edmond; Khoury, Elie; Cacciafesta, Vittorio; Naaman, Nada

    2016-11-01

    The aim of this article was to evaluate the impact of intraoral aging and site specificity on debris accumulation and friction in molar tubes after intraoral use. A total of 80 intraorally used first molar convertible tubes were provided by 20 orthodontic adolescent patients after 6 months of treatment. The specimens were divided into eight groups (n = 10) according to the mouth quadrant and the type of examination [four groups of ten tubes for scanning electron microscope (SEM) and four groups of ten tubes for friction test]. Scanning electron microscope examination was performed after opening the convertible caps and friction test was executed using a 0.019'' × 0.025'' stainless steel wire, which was inserted in the tubes belonging to each group. The Mann-Whitney test, analysis of variance (ANOVA), and Bonferroni tests were performed for statistical analysis at 0.01 level of significance. There was a significant increase in the amount of debris and frictional force after 6 months of intraoral exposure (p < 0.0001). Debris scores were higher (10% increase) on the upper tubes when compared with the lower ones, with no statistical difference. Mean frictional force ranged from 0.22 to 0.26 N according to the mouth quadrant, but the difference between groups was also not significant. After 6 months of intraoral exposure, there was a significant increase in the amount of debris in the first molar tube slots, leading to significantly higher frictional forces during sliding mechanics. The influence of site specificity on the amount of debris and on frictional forces of the first molar tubes could not be demonstrated. Molar tubes should be cleaned, before and during sliding mechanics, in order to minimize friction.

  12. Differential impact of partial cortical blindness on gaze strategies when sitting and walking - an immersive virtual reality study

    PubMed Central

    Iorizzo, Dana B.; Riley, Meghan E.; Hayhoe, Mary; Huxlin, Krystel R.

    2011-01-01

    The present experiments aimed to characterize the visual performance of subjects with long-standing, unilateral cortical blindness when walking in a naturalistic, virtual environment. Under static, seated testing conditions, cortically blind subjects are known to exhibit compensatory eye movement strategies. However, they still complain of significant impairment in visual detection during navigation. To assess whether this is due to a change in compensatory eye movement strategy between sitting and walking, we measured eye and head movements in subjects asked to detect peripherally-presented, moving basketballs. When seated, cortically blind subjects detected ~80% of balls, while controls detected almost all balls. Seated blind subjects did not make larger head movements than controls, but they consistently biased their fixation distribution towards their blind hemifield. When walking, head movements were similar in the two groups, but the fixation bias decreased to the point that fixation distribution in cortically blind subjects became similar to that in controls - with one major exception: at the time of basketball appearance, walking controls looked primarily at the far ground, in upper quadrants of the virtual field of view; cortically blind subjects looked significantly more at the near ground, in lower quadrants of the virtual field. Cortically blind subjects detected only 58% of the balls when walking while controls detected ~90%. Thus, the adaptive gaze strategies adopted by cortically blind individuals as a compensation for their visual loss are strongest and most effective when seated and stationary. Walking significantly alters these gaze strategies in a way that seems to favor walking performance, but impairs peripheral target detection. It is possible that this impairment underlies the experienced difficulty of those with cortical blindness when navigating in real life. PMID:21414339

  13. Differential impact of partial cortical blindness on gaze strategies when sitting and walking - an immersive virtual reality study.

    PubMed

    Iorizzo, Dana B; Riley, Meghan E; Hayhoe, Mary; Huxlin, Krystel R

    2011-05-25

    The present experiments aimed to characterize the visual performance of subjects with long-standing, unilateral cortical blindness when walking in a naturalistic, virtual environment. Under static, seated testing conditions, cortically blind subjects are known to exhibit compensatory eye movement strategies. However, they still complain of significant impairment in visual detection during navigation. To assess whether this is due to a change in compensatory eye movement strategy between sitting and walking, we measured eye and head movements in subjects asked to detect peripherally-presented, moving basketballs. When seated, cortically blind subjects detected ∼80% of balls, while controls detected almost all balls. Seated blind subjects did not make larger head movements than controls, but they consistently biased their fixation distribution towards their blind hemifield. When walking, head movements were similar in the two groups, but the fixation bias decreased to the point that fixation distribution in cortically blind subjects became similar to that in controls - with one major exception: at the time of basketball appearance, walking controls looked primarily at the far ground, in upper quadrants of the virtual field of view; cortically blind subjects looked significantly more at the near ground, in lower quadrants of the virtual field. Cortically blind subjects detected only 58% of the balls when walking while controls detected ∼90%. Thus, the adaptive gaze strategies adopted by cortically blind individuals as a compensation for their visual loss are strongest and most effective when seated and stationary. Walking significantly alters these gaze strategies in a way that seems to favor walking performance, but impairs peripheral target detection. It is possible that this impairment underlies the experienced difficulty of those with cortical blindness when navigating in real life. Copyright © 2011 Elsevier Ltd. All rights reserved.

  14. [Application of serratus anterior muscle flap combined with breast implants for breast reconstruction after modified radical mastectomy].

    PubMed

    Chai, Lijun; Zhang, Xuehui

    2017-09-01

    To investigate effectiveness of the combination of serratus anterior muscle flap and breast implants for breast reconstruction after modified radical mastectomy. Between January 2015 and December 2015, 25 female patients with breast cancer were enrolled, aged 24-62 years (mean, 40.6 years). The tumor located at left side in 9 cases and right side in 16 cases; 14 cases were in the left upper quadrant, 4 cases were in the left lower quadrant, 7 cases were on the top of the breast. All cases were invasive ductal carcinoma. According to TNM staging, 14 cases were at stageⅠand 11 cases were at stageⅡA. The diameter of lumps were all less than 3 cm. All those lumps were solitary and without distant metastasis. The sentinel nodes were all negative. After modified radical mastectomy, the breasts were reconstructed by serratus anterior muscle flap and breast implants. The nipples were spared in 22 cases. The operation time was 113-148 minutes (mean, 136 minutes). All breasts survived and incisions healed at stageⅠ. There was no complication such as hematoma, infection, etc . All patients were followed up 6-18 months (mean, 15 months). Except 1 case, the others were evaluated according to the criteria of the reconstructed breast at 12 months after operation. Among them, 23 cases were evaluated as good and 1 case as fair. There was no tumor recurrence during the follow-up period. The combination of serratus anterior muscle flap and breast implants after the modified radical mastectomy is a handy approach of breast reconstruction which is less harmful with few postoperative complications. It also gains a high degree of satisfaction from patients for good breast shape.

  15. Effects of low-intensity laser therapy on the rate of orthodontic tooth movement: A clinical trial

    PubMed Central

    Kansal, Ankur; Kittur, Nandan; Kumbhojkar, Vinayak; Keluskar, Kanhoba Mahabaleshwar; Dahiya, Parveen

    2014-01-01

    Background: Low-intensity laser therapy (LILT) can be utilized for different treatments in the field of orthodontics and dentofacial orthopedics. The aim of the present study was to evaluate the efficacy of LILT on (1) the rate of canine movement during canine retraction phase and (2) evaluate the radiographic changes occurring during LILT around the irradiated area. Materials and Methods: A total of 10 patients of both genders were included for this study. One quadrant of the upper arch was considered control group (CG) and received mechanical activation of the canine teeth with 150 g. The opposite quadrant received the same mechanical activation and was also irradiated with a diode emitting light (gallium-arsenide laser) at 904 nm, for 10 s at 12 mW, at 4.2 J/cm2. Laser application was done on 1st day, 3rd, 7th, 14th, 21th, 28th, 35th, 42nd, 49th, 56th day respectively during the canine retraction phase. Distance was measured on 1st day, 35th day and 63rd day and appliance activation was done on 1st and 35th day. Results were analyzed using t-test with the significance level set at P < 0.01. Results: Mean value obtained from 1st to 63rd day was 3.30 ± 2.36 mm for CG and 3.53 ± 2.30 mm for laser group (LG). Conclusion: There was no statistically significant difference in the rate of tooth movement during canine retraction between the LG and the CG. There was no evidence of any pathologic changes in the radiograph following LILT. PMID:25225562

  16. [Comparison of anterior chamber angle examination by UBM, SL-OCT and gonioscopy].

    PubMed

    Liu, Rui-jue; Wang, Men; Xia, Wen-tao; Yu, Xiao-ying; Chen, Jie-min; Zhou, Shu; Peng, Shu-ya; Liu, Dong-mei

    2014-08-01

    To compare the agreement of anterior chamber angle examination by ultrasound biomicroscope (UBM), slit lamp optical coherence tomography (SL-OCT), and gonioscopy in angle recession and angle closure. The anterior chamber angle was measured with UBM, SL-OCT and gonioscopy in turns for temporal, nasal, superior and inferior quadrant in the same dark room. The results were compared with the agreement of the three methods in angle recession and angle closure by χ2 test and Kappa test. There were no statistically significant differences of the three methods in testing angle closure and angle recession (P>0.05). The consistency of UBM and gonioscopy was better (Kappa value of 0.882) than that of SL-OCT and gonioscopy (Kappa value of 0.624). When testing angle recession, UBM is better than SL-OCT with gonioscopy as the standard. When testing angle closure, UBM, SL-OCT and gonioscopy have good agreement.

  17. EIT: Solar corona synoptic observations from SOHO with an Extreme-ultraviolet Imaging Telescope

    NASA Technical Reports Server (NTRS)

    Delaboudiniere, J. P.; Gabriel, A. H.; Artzner, G. E.; Michels, D. J.; Dere, K. P.; Howard, R. A.; Catura, R.; Stern, R.; Lemen, J.; Neupert, W.

    1988-01-01

    The Extreme-ultraviolet Imaging Telescope (EIT) of SOHO (solar and heliospheric observatory) will provide full disk images in emission lines formed at temperatures that map solar structures ranging from the chromospheric network to the hot magnetically confined plasma in the corona. Images in four narrow bandpasses will be obtained using normal incidence multilayered optics deposited on quadrants of a Ritchey-Chretien telescope. The EIT is capable of providing a uniform one arc second resolution over its entire 50 by 50 arc min field of view. Data from the EIT will be extremely valuable for identifying and interpreting the spatial and temperature fine structures of the solar atmosphere. Temporal analysis will provide information on the stability of these structures and identify dynamical processes. EIT images, issued daily, will provide the global corona context for aid in unifying the investigations and in forming the observing plans for SOHO coronal instruments.

  18. Dental health state utility values associated with tooth loss in two contrasting cultures.

    PubMed

    Nassani, M Z; Locker, D; Elmesallati, A A; Devlin, H; Mohammadi, T M; Hajizamani, A; Kay, E J

    2009-08-01

    The study aimed to assess the value placed on oral health states by measuring the utility of mouths in which teeth had been lost and to explore variations in utility values within and between two contrasting cultures, UK and Iran. One hundred and fifty eight patients, 84 from UK and 74 from Iran, were recruited from clinics at University-based faculties of dentistry. All had experienced tooth loss and had restored or unrestored dental spaces. They were presented with 19 different scenarios of mouths with missing teeth. Fourteen involved the loss of one tooth and five involved shortened dental arches (SDAs) with varying numbers of missing posterior teeth. Each written description was accompanied by a verbal explanation and digital pictures of mouth models. Participants were asked to indicate on a standardized Visual Analogue Scale how they would value the health of their mouth if they had lost the tooth/teeth described and the resulting space was left unrestored. With a utility value of 0.0 representing the worst possible health state for a mouth and 1.0 representing the best, the mouth with the upper central incisor missing attracted the lowest utility value in both samples (UK = 0.16; Iran = 0.06), while the one with a missing upper second molar the highest utility values (0.42, 0.39 respectively). In both countries the utility value increased as the tooth in the scenario moved from the anterior towards the posterior aspect of the mouth. There were significant differences in utility values between UK and Iranian samples for four scenarios all involving the loss of anterior teeth. These differences remained after controlling for gender, age and the state of the dentition. With respect to the SDA scenarios, a mouth with a SDA with only the second molar teeth missing in all quadrants attracted the highest utility values, while a mouth with an extreme SDA with both missing molar and premolar teeth in all quadrants attracted the lowest utility values. The study provided further evidence of the validity of the scaling approach to utility measurement in mouths with missing teeth. Some cross-cultural variations in values were observed but these should be viewed with due caution because the magnitude of the differences was small.

  19. Comparative evaluation of pentraxin 3 levels in GCF during canine retraction with active tieback and NiTi coil spring: An in vivo study.

    PubMed

    Patel, Pratik; Shanthraj, Ravi; Bhagyalakshmi, A; Garg, Nekta; Vallakati, Anisha

    2016-01-01

    To compare the levels of pentraxin 3 (PTX-3) in gingival crevicular fluid (GCF) in patients undergoing orthodontic canine retraction with active tieback and nickel titanium (NiTi) coil spring. Fifteen patients of the age group 15-25 years with first premolar extraction undergoing canine retraction were selected. One month after placement of 0.019" × 0.025" stainless steel wire, canine retraction was started with active tieback (150 g force) on upper right quadrant and NiTi coil spring (150 g force) on upper left quadrant. GCF samples were collected 1 h before commencement of canine retraction and thereafter at intervals of 1 h, 1 day, 1 week, and 2 weeks after application of force. The collected GCF was eluted from the microcapillary pipette in 100 μl phosphate-buffered saline (pH 5-7.2). The samples were analyzed for PTX-3 levels by the ELISA technique. The mean levels of PTX-3 at 1 h before canine retraction (baseline) was 1.30 ± 0.22 ng/ml and at 1 h 1.66 ± 0.33 ng/ml, 1 day 2.65 ± 0.09 ng/ml, 1 week 1.96 ± 0.15 ng/ml, and 2 weeks 1.37 ± 0.18 ng/ml in active tieback group. The mean levels of PTX-3 at 1 h before canine retraction was 1.32 ± 0.30 ng/ml, and at 1 h 1.71 ± 0.39 ng/ml, 1 day 2.78 ± 0.12 ng/ml, 1 week 2.52 ± 0.18 ng/ml, and 2 weeks 2.12 ± 0.17 ng/ml in NiTi coil spring group. A significant difference of P < 0.001 was found in PTX-3 levels in GCF during canine retraction between active tieback and NiTi coil spring at 1 day, 1 week, and 2 weeks. The results showed that PTX-3 levels increased from 1 h after application of orthodontic force and reached peak at 1 day, followed by a gradual decrease at 1 week and 2 weeks in both active tie back and NiTi coil spring groups.

  20. A description of externally recorded womb sounds in human subjects during gestation

    PubMed Central

    Daland, Robert; Kesavan, Kalpashri; Macey, Paul M.; Zeltzer, Lonnie; Harper, Ronald M.

    2018-01-01

    Objective Reducing environmental noise benefits premature infants in neonatal intensive care units (NICU), but excessive reduction may lead to sensory deprivation, compromising development. Instead of minimal noise levels, environments that mimic intrauterine soundscapes may facilitate infant development by providing a sound environment reflecting fetal life. This soundscape may support autonomic and emotional development in preterm infants. We aimed to assess the efficacy and feasibility of external non-invasive recordings in pregnant women, endeavoring to capture intra-abdominal or womb sounds during pregnancy with electronic stethoscopes and build a womb sound library to assess sound trends with gestational development. We also compared these sounds to popular commercial womb sounds marketed to new parents. Study design Intra-abdominal sounds from 50 mothers in their second and third trimester (13 to 40 weeks) of pregnancy were recorded for 6 minutes in a quiet clinic room with 4 electronic stethoscopes, placed in the right upper and lower quadrants, and left upper and lower quadrants of the abdomen. These recording were partitioned into 2-minute intervals in three different positions: standing, sitting and lying supine. Maternal and gestational age, Body Mass Index (BMI) and time since last meal were collected during recordings. Recordings were analyzed using long-term average spectral and waveform analysis, and compared to sounds from non-pregnant abdomens and commercially-marketed womb sounds selected for their availability, popularity, and claims they mimic the intrauterine environment. Results Maternal sounds shared certain common characteristics, but varied with gestational age. With fetal development, the maternal abdomen filtered high (500–5,000 Hz) and mid-frequency (100–500 Hz) energy bands, but no change appeared in contributions from low-frequency signals (10–100 Hz) with gestational age. Variation appeared between mothers, suggesting a resonant chamber role for intra-abdominal space. Compared to commercially-marketed sounds, womb signals were dominated by bowel sounds, were of lower frequency, and showed more variation in intensity. Conclusions High-fidelity intra-abdominal or womb sounds during pregnancy can be recorded non-invasively. Recordings vary with gestational age, and show a predominance of low frequency noise and bowel sounds which are distinct from popular commercial products. Such recordings may be utilized to determine whether sounds influence preterm infant development in the NICU. PMID:29746604

  1. A description of externally recorded womb sounds in human subjects during gestation.

    PubMed

    Parga, Joanna J; Daland, Robert; Kesavan, Kalpashri; Macey, Paul M; Zeltzer, Lonnie; Harper, Ronald M

    2018-01-01

    Reducing environmental noise benefits premature infants in neonatal intensive care units (NICU), but excessive reduction may lead to sensory deprivation, compromising development. Instead of minimal noise levels, environments that mimic intrauterine soundscapes may facilitate infant development by providing a sound environment reflecting fetal life. This soundscape may support autonomic and emotional development in preterm infants. We aimed to assess the efficacy and feasibility of external non-invasive recordings in pregnant women, endeavoring to capture intra-abdominal or womb sounds during pregnancy with electronic stethoscopes and build a womb sound library to assess sound trends with gestational development. We also compared these sounds to popular commercial womb sounds marketed to new parents. Intra-abdominal sounds from 50 mothers in their second and third trimester (13 to 40 weeks) of pregnancy were recorded for 6 minutes in a quiet clinic room with 4 electronic stethoscopes, placed in the right upper and lower quadrants, and left upper and lower quadrants of the abdomen. These recording were partitioned into 2-minute intervals in three different positions: standing, sitting and lying supine. Maternal and gestational age, Body Mass Index (BMI) and time since last meal were collected during recordings. Recordings were analyzed using long-term average spectral and waveform analysis, and compared to sounds from non-pregnant abdomens and commercially-marketed womb sounds selected for their availability, popularity, and claims they mimic the intrauterine environment. Maternal sounds shared certain common characteristics, but varied with gestational age. With fetal development, the maternal abdomen filtered high (500-5,000 Hz) and mid-frequency (100-500 Hz) energy bands, but no change appeared in contributions from low-frequency signals (10-100 Hz) with gestational age. Variation appeared between mothers, suggesting a resonant chamber role for intra-abdominal space. Compared to commercially-marketed sounds, womb signals were dominated by bowel sounds, were of lower frequency, and showed more variation in intensity. High-fidelity intra-abdominal or womb sounds during pregnancy can be recorded non-invasively. Recordings vary with gestational age, and show a predominance of low frequency noise and bowel sounds which are distinct from popular commercial products. Such recordings may be utilized to determine whether sounds influence preterm infant development in the NICU.

  2. Diagnostic Capability of Peripapillary Retinal Volume Measurements in Glaucoma.

    PubMed

    Simavli, Huseyin; Poon, Linda Yi-Chieh; Que, Christian J; Liu, Yingna; Akduman, Mustafa; Tsikata, Edem; de Boer, Johannes F; Chen, Teresa C

    2017-06-01

    To determine the diagnostic capability of spectral domain optical coherence tomography peripapillary retinal volume (RV) measurements. A total of 156 patients, 89 primary open-angle glaucoma and 67 normal subjects, were recruited. Spectral domain optical coherence tomography peripapillary RV was calculated for 4 quadrants using 3 annuli of varying scan circle diameters: outer circumpapillary annuli of circular grids 1, 2, and 3 (OCA1, OCA2, OCA3). Area under the receiver operating characteristic curves and pairwise comparisons of receiver operating characteristic (ROC) curves were performed to determine which quadrants were best for diagnosing primary open-angle glaucoma. The pairwise comparisons of the best ROC curves for RV and retinal nerve fiber layer (RNFL) were performed. The artifact rates were analyzed. Pairwise comparisons showed that the smaller annuli OCA1 and OCA2 had better diagnostic performance than the largest annulus OCA3 (P<0.05 for all quadrants). OCA1 and OCA2 had similar diagnostic performance, except for the inferior quadrant which was better for OCA1 (P=0.0033). The pairwise comparisons of the best ROC curves for RV and RNFL were not statistically significant. RV measurements had lower rates of artifacts at 7.4% while RNFL measurements had higher rates at 42.9%. Peripapillary RV measurements have excellent ability for diagnosing not only glaucoma patients but also a subset of early glaucoma patients. The inferior quadrant of peripapillary annulus OCA1 demonstrated the best diagnostic capability for both glaucoma and early glaucoma. The diagnostic ability of RV is comparable with that of RNFL parameters in glaucoma but with lower artifact rates.

  3. Diagnostic Capability of Peripapillary Retinal Volume Measurements in Glaucoma

    PubMed Central

    Simavli, Huseyin; Poon, Linda Yi-Chieh; Que, Christian John; Liu, Yingna; Akduman, Mustafa; Tsikata, Edem; de Boer, Johannes F.; Chen, Teresa C.

    2017-01-01

    Purpose To determine the diagnostic capability of spectral domain optical coherence tomography (SD-OCT) peripapillary retinal volume (RV) measurements. Materials and Methods A total of 156 patients, 89 primary open angle (POAG) and 67 normal subjects, were recruited. SD-OCT peripapillary RV was calculated for four quadrants using 3 annuli of varying scan circle diameters: outer circumpapillary annuli of circular grids 1, 2, and 3 (OCA1, OCA2, OCA3). Area under the receiver operating characteristic (AUROC) curves and pairwise comparisons of receiver operating characteristic (ROC) curves were performed to determine which quadrants were best for diagnosing POAG. The pairwise comparisons of the best ROC curves for RV and RNFL were performed. The artifact rates were analyzed. Results Pairwise comparisons showed that the smaller annuli OCA1 and OCA2 had better diagnostic performance than the largest annulus OCA3 (p<0.05 for all quadrants). OCA1 and OCA2 had similar diagnostic performance, except for the inferior quadrant which was better for OCA1 (p=0.0033).The pairwise comparisons of the best ROC curves for RV and RNFL were not statistically significant. Retinal volume measurements had lower rates of artifacts at 7.4% while RNFL measurements had higher rates at 42.9%. Conclusion Peripapillary RV measurements have excellent ability for diagnosing not only glaucoma patients but also a subset of early glaucoma patients. The inferior quadrant of peripapillary annulus OCA1 demonstrated the best diagnostic capability for both glaucoma and early glaucoma. The diagnostic ability of RV is comparable to that of RNFL parameters in glaucoma but with lower artifact rates. PMID:28079657

  4. Comparing the efficiency of Er,Cr:YSGG laser and diode laser on human β-defensin-1 and IL-1β levels during the treatment of generalized aggressive periodontitis and chronic periodontitis.

    PubMed

    Ertugrul, Abdullah Seckin; Tekin, Yasin; Talmac, Ahmet Cemil

    2017-11-01

    The aim of this study is to determine the suitability of the Er,Cr:YSGG and 940 ± 15-nm diode laser for the treatment of generalized aggressive periodontitis and chronic periodontitis by measuring the levels of human β-defensin-1 and IL-1β. A total of 26 patients were included in this study. The study was designed as a "split-mouth" experiment. We performed scaling and root planing in the right maxillary quadrant, scaling and root planning + Er,Cr:YSGG laser in the left maxillary quadrant, scaling and root planning + 940 ± 15-nm diode laser in the left mandibular quadrant, and only scaling and root planing in the right mandibular quadrant. The presence of human β-defensin-1 and IL-1β was analyzed with an ELISA. When the baseline and post-treatment human β-defensin-1 levels and IL-1β levels of the study groups were evaluated, a decrease in human β-defensin-1 and IL-1β were observed in the quadrant where the Er,Cr:YSGG laser was applied in both the generalized aggressive periodontitis group and the chronic periodontitis group. The use of the Er,Cr:YSGG laser at non-surgical periodontal treatment decreased both IL-1β and human β-defensin-1 levels. It is likely that Er,Cr:YSGG laser is more suitable for the treatment of generalized aggressive periodontitis and chronic periodontitis.

  5. Change in intraocular pressure during scleral depression.

    PubMed

    Trevino, Richard; Stewart, Brandi

    2015-01-01

    Manometric studies have found that intraocular pressure (IOP) rises 116-350 mmHg during scleral depression in surgical settings. No information is available regarding the effect of scleral depression on IOP in routine clinical settings. The aim of this study is to quantify the change in IOP that occurs when scleral depression is performed on normal eyes in a routine clinical setting. A total of 28 eyes from 28 normal subjects were included. Tono-Pen tonometry was performed while scleral depression was performed in each of the two quadrants: superotemporal (ST) and inferonasal (IN). A post-procedure IOP measurement was obtained following each scleral depression examination. Both ST and IN quadrants were tested on all eyes, with the quadrant tested first chosen at random (15 ST, 13 IN). The mean IOP during scleral depression was 65.3 mmHg ST and 47.8 mmHg IN, with a maximum recorded IOP of 88 mmHg. The mean change in IOP for the ST quadrant was 51.9 ± 17.3 mmHg and 46.4 ± 16.0 mmHg for the right and left eyes, respectively. The mean change in IOP for the IN quadrant was 45.3 ± 22.7 mmHg and 16.8 ± 15.8 mmHg for the right and left eyes, respectively. Scleral depression as performed in a routine office setting produces wide fluctuations in IOP and may impair ocular perfusion. Additional studies are needed to determine the long-term consequences of routine scleral depression. Copyright © 2014 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

  6. Survival estimates for Florida manatees from the photo-identification of individuals

    USGS Publications Warehouse

    Langtimm, C.A.; Beck, C.A.; Edwards, H.H.; Fick-Child, K. J.; Ackerman, B.B.; Barton, S.L.; Hartley, W.C.

    2004-01-01

    We estimated adult survival probabilities for the endangered Florida manatee (Trichechus manatus latirostris) in four regional populations using photo-identification data and open-population capture-recapture statistical models. The mean annual adult survival probability over the most recent 10-yr period of available estimates was as follows: Northwest - 0.956 (SE 0.007), Upper St. Johns River - 0.960 (0.011), Atlantic Coast - 0.937 (0.008), and Southwest - 0.908 (0.019). Estimates of temporal variance independent of sampling error, calculated from the survival estimates, indicated constant survival in the Upper St. Johns River, true temporal variability in the Northwest and Atlantic Coast, and large sampling variability obscuring estimates for the Southwest. Calf and subadult survival probabilities were estimated for the Upper St. Johns River from the only available data for known-aged individuals: 0.810 (95% CI 0.727-0.873) for 1st year calves, 0.915 (0.827-0.960) for 2nd year calves, and 0.969 (0.946-0.982) for manatee 3 yr or older. These estimates of survival probabilities and temporal variance, in conjunction with estimates of reproduction probabilities from photoidentification data can be used to model manatee population dynamics, estimate population growth rates, and provide an integrated measure of regional status.

  7. 18 CFR 38.2 - Incorporation by reference of North American Energy Standards Board Wholesale Electric Quadrant...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Wholesale Electric Quadrant, which are incorporated herein by reference: (1) Open Access Same-Time....13, 001-1.0, 001-9.7, 001-14.1.3, and 001-15.1.2); (2) Open Access Same-Time Information Systems... minor corrections applied May 29, 2009 and September 8, 2009); (3) Open Access Same-Time Information...

  8. 18 CFR 38.2 - Incorporation by reference of North American Energy Standards Board Wholesale Electric Quadrant...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... Wholesale Electric Quadrant, which are incorporated herein by reference: (1) Open Access Same-Time....13, 001-1.0, 001-9.7, 001-14.1.3, and 001-15.1.2); (2) Open Access Same-Time Information Systems... minor corrections applied May 29, 2009 and September 8, 2009); (3) Open Access Same-Time Information...

  9. 67. Photocopy of Rudder Bearing Quadrant, Skeg and Rudder Stops. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    67. Photocopy of Rudder Bearing Quadrant, Skeg and Rudder Stops. Erie Concrete & Steel Supply Company, Shipbuilding Division, Erie, Pennsylvania. Coast Guard Headquarters Drawing No. 540-WAGL-2200-17 (right side), dated May 1943. Original drawing property of the U.S. Coast Guard. - U.S. Coast Guard Cutter WHITE HEATH, USGS Integrated Support Command Boston, 427 Commercial Street, Boston, Suffolk County, MA

  10. 66. Photocopy of Rudder Bearing Quadrant, Skeg and Rudder Stops. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    66. Photocopy of Rudder Bearing Quadrant, Skeg and Rudder Stops. Erie Concrete & Steel Supply Company, Shipbuilding Division, Erie, Pennsylvania. Coast Guard Headquarters Drawing No. 540-WAGL-2200-17 (left side), dated May 1943. Original drawing property of the U.S. Coast Guard. - U.S. Coast Guard Cutter WHITE HEATH, USGS Integrated Support Command Boston, 427 Commercial Street, Boston, Suffolk County, MA

  11. 18 CFR 38.2 - Incorporation by reference of North American Energy Standards Board Wholesale Electric Quadrant...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ....13, 001-1.0, 001-9.7, 001-14.1.3, and 001-15.1.2); (2) Open Access Same-Time Information Systems... reference of North American Energy Standards Board Wholesale Electric Quadrant standards. 38.2 Section 38.2... UTILITIES § 38.2 Incorporation by reference of North American Energy Standards Board Wholesale Electric...

  12. Commentary--Of Quadrants and Fish Scales: Reflections on New Directions in Research in Child and Adolescent Development

    ERIC Educational Resources Information Center

    Beckmann, Jens F.

    2015-01-01

    In this article, I reflect on how ways of reporting research as well as reviewing and commenting on submitted manuscripts could take new directions to promote progress in the discipline of developmental science. I argue for (a) attitudinal openness toward migratory impulses in relation to Stokes's quadrant model of science, (b) the…

  13. 76 FR 61561 - Airworthiness Directives; The Boeing Company Model 737-600, -700, -700C, -800, -900, and -900ER...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-05

    ... AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Final rule. SUMMARY: We are adopting a new... clearance and any wire bundle damage between wire bundle W443 and the left forward rudder quadrant, followed by adjusting the minimum clearance between the wire bundle and the left forward rudder quadrant, and...

  14. 76 FR 2840 - Airworthiness Directives; The Boeing Company Model 737-600, -700, -700C, -800, -900, and -900ER...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-18

    ...: We propose to adopt a new airworthiness directive (AD) for certain Model 737-600, -700, -700C, -800... and any wire bundle damage between wire bundle W443 and the left forward rudder quadrant, followed by adjusting the minimum clearance between the wire bundle and the left forward rudder quadrant, and repairing...

  15. Concerning the Motion of FTEs and Attendant Signatures

    NASA Technical Reports Server (NTRS)

    Sibeck, David G.

    2010-01-01

    We employ the Cooling et al. [2001] model to predict the location, orientation, and motion of flux transfer events (FTEs) generated along finite length component and anti parallel reconnection lines for typical solar wind plasma conditions and various interplanetary magnetic field (IMF) orientations in the plane perpendicular to the SunEarth line at the solstices and equinoxes. For duskward and northward or southward IMF orientations, events formed by component reconnection originate along reconnection curves passing through the sub solar point that tilt from southern dawn to northern dusk. They maintain this orientation as they move either northward into the northern dawn quadrant or southward into the southern dusk quadrant. By contrast, events formed by antiparallel reconnection originate along reconnection curves running from northern dawn to southern dusk in the southern dawn and northern dusk quadrants and maintain these orientations as they move anti sunward into both these quadrants. Although both the component and antiparallel reconnection models can explain previously reported event orientations on the southern dusk magnetopause during intervals of northward and dawn ward IMF orientation, only the component model explains event occurrence near the subsolar magnetopause during intervals when the IMF does not point due southward.

  16. Array Formatting of the Heat-Transfer Method (HTM) for the Detection of Small Organic Molecules by Molecularly Imprinted Polymers

    PubMed Central

    Wackers, Gideon; Vandenryt, Thijs; Cornelis, Peter; Kellens, Evelien; Thoelen, Ronald; De Ceuninck, Ward; Losada-Pérez, Patricia; van Grinsven, Bart; Peeters, Marloes; Wagner, Patrick

    2014-01-01

    In this work we present the first steps towards a molecularly imprinted polymer (MIP)-based biomimetic sensor array for the detection of small organic molecules via the heat-transfer method (HTM). HTM relies on the change in thermal resistance upon binding of the target molecule to the MIP-type receptor. A flow-through sensor cell was developed, which is segmented into four quadrants with a volume of 2.5 μL each, allowing four measurements to be done simultaneously on a single substrate. Verification measurements were conducted, in which all quadrants received a uniform treatment and all four channels exhibited a similar response. Subsequently, measurements were performed in quadrants, which were functionalized with different MIP particles. Each of these quadrants was exposed to the same buffer solution, spiked with different molecules, according to the MIP under analysis. With the flow cell design we could discriminate between similar small organic molecules and observed no significant cross-selectivity. Therefore, the MIP array sensor platform with HTM as a readout technique, has the potential to become a low-cost analysis tool for bioanalytical applications. PMID:24955945

  17. Right Lower Quadrant Pain in a Young Female: Ultrasound Diagnosis of Rectus Abdominis Tear.

    PubMed

    Minardi, Joseph; Shaver, Erica; Monseau, Aaron; Pratt, Adam; Layman, Shelley M

    2015-11-01

    Right lower quadrant pain in young females presents a frequent diagnostic challenge for emergency physicians, with a broad differential and several important diagnoses. Using an "ultrasound first" imaging strategy can help decrease the use of computed tomography scans, with associated savings in radiation exposure, cost, and other resource use. We report a case of right lower quadrant pain in a young woman. After her initial history and physical examination, appendicitis was the leading differential. A bedside ultrasound was performed, leading to the uncommon diagnosis of rectus abdominis muscle tear. The sonographic findings of a muscle tear include increase in size, loss of linear, homogeneous architecture, and decreased echogenicity. Making this diagnosis at the bedside using ultrasound obviated the need for further imaging, avoiding unnecessary radiation exposure, and decreasing emergency department length of stay and overall cost, while leading to a tailored treatment plan. Why Should an Emergency Physician Be Aware of This? Rectus abdominis tear is a cause of right lower quadrant pain that may mimic appendicitis and should be considered in patients with this complaint. The ability to make this diagnosis with bedside ultrasound may assist in several important patient-oriented outcomes. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Reliability testing of ultra-low noise InGaAs quad photoreceivers

    NASA Astrophysics Data System (ADS)

    Joshi, Abhay M.; Datta, Shubhashish; Prasad, Narasimha; Sivertz, Michael

    2018-02-01

    We have developed ultra-low noise quadrant InGaAs photoreceivers for multiple applications ranging from Laser Interferometric Gravitional Wave Detection, to 3D Wind Profiling. Devices with diameters of 0.5 mm, 1mm, and 2 mm were processed, with the nominal capacitance of a single quadrant of a 1 mm quad photodiode being 2.5 pF. The 1 mm diameter InGaAs quad photoreceivers, using a low-noise, bipolar-input OpAmp circuitry exhibit an equivalent input noise per quadrant of <1.7 pA/√Hz in 2 to 20 MHz frequency range. The InGaAs Quad Photoreceivers have undergone the following reliability tests: 30 MeV Proton Radiation up to a Total Ionizing Dose (TID) of 50 krad, Mechanical Shock, and Sinusoidal Vibration.

  19. Operative technique and early experience for robotic-assisted laparoscopic nephroureterectomy (RALNU) using da Vinci Xi.

    PubMed

    Darwiche, Fadi; Swain, Sanjaya; Kallingal, George; Punnen, Sanoj; Manoharan, Murugesan; Parekh, Dipen J; Gonzalgo, Mark L

    2015-01-01

    Robotic-assisted laparoscopic nephroureterectomy (RALNU) has been previously utilized for management of upper tract urothelial carcinoma. The da Vinci Xi surgical system was released in April of 2014. We describe our operative technique and early experience for RALNU using the da Vinci Xi system highlighting unique features of this surgical platform. A total of 10 patients with a diagnosis of upper tract urothelial carcinoma underwent RALNU using the da Vinci Xi system between April and November of 2014. A novel, oblique "in line" robotic trocar configuration was utilized to access the upper abdomen (nephrectomy portion) and pelvis (bladder cuff excision) without undocking. The port hopping feature of da Vinci Xi was utilized to facilitate optimal, multi-quadrant visualization during RALNU. Robotic-assisted laparoscopic nephroureterectomy was successfully completed without open conversion in all 10 patients. Mean operative time was 184 min (range 140-300 min), mean estimated blood loss was 121 cc (range 60-300 cc), and mean hospital stay was 2.4 days. Final pathology demonstrated high grade urothelial carcinoma in all patients. Surgical margins were negative in all patients. No intra-operative complications were encountered. One patient developed a pulmonary embolus after being discharged. No patients required a blood transfusion. Mean patient follow-up was 130 days (range 15-210 days). The use of da Vinci Xi with a novel, oblique "in line" port configuration and camera port hopping technique allows for an efficient and reproducible method for RALNU without the need for repositioning the patient or the robot during surgery.

  20. Arm and neck pain in ultrasonographers.

    PubMed

    Claes, Frank; Berger, Jan; Stassijns, Gaëtane

    2015-03-01

    The aim of this study was to evaluate the prevalence of upper-body-quadrant pain among ultrasonographers and to evaluate the association between individual ergonomics, musculoskeletal disorders, and occurrence of neck pain. A hundred and ten (N = 110) Belgian and Dutch male and female hospital ultrasonographers were consecutively enrolled in the study. Data on work-related ergonomic and musculoskeletal disorders were collected with an electronic inquiry, including questions regarding ergonomics (position of the screen, high-low table, and ergonomic chair), symptoms (neck pain, upper-limb pain), and work-related factors (consecutive working hours a day, average working hours a week). Subjects with the screen on their left had significantly more neck pain (odds ratio [OR] = 3.6, p = .0286). Depending on the workspace, high-low tables increased the chance of developing neck pain (OR = 12.9, p = .0246). A screen at eye level caused less neck pain (OR = .22, p = .0610). Employees with a fixed working space were less susceptible to arm pain (OR = 0.13, p = .0058). The prevalence of arm pain was significantly higher for the vascular department compared to radiology, urology, and gynecology departments (OR = 9.2, p = .0278). Regarding prevention of upper-limb pain in ultrasonograph, more attention should be paid to the work environment and more specialty to the ultrasound workstation layout. Primary ergonomic prevention could provide a painless work situation for the ultrasonographer. Further research on the ergonomic conditions of ultrasonography is necessary to develop ergonomic solutions in the work environment that will help to alleviate neck and arm pain. © 2014, Human Factors and Ergonomics Society.

  1. Interchangeability and reliability of macular perfusion parameter measurements using optical coherence tomography angiography

    PubMed Central

    Dong, Jing; Jia, Ya-ding; Wu, Qiang; Zhang, Suhua; Jia, Yali; Huang, David; Wang, Xiaogang

    2018-01-01

    Aim The aim of the study was to investigate the interchangeability and reliability of macular perfusion measurements using optical coherence tomography angiography. Methods A prospective cross-sectional observational study. Healthy adult Chinese subjects were recruited. Macular perfusion parameters were automatically analysed by software included in a spectral-domain optical coherence tomography system. The vessel density (VD) of the whole, parafovea, superior-hemi, inferior-hemi, fovea, temporal, superior, nasal and inferior quadrants as well as the foveal avascular zone (FAZ) and choroidal capillary VD (CCVD) were quantified. Results A total of 51 eyes in 27 subjects were included (8 men and 19 women, mean age 24±4 years). Significant differences in VD of all quadrants (all p<0.001) was detected between the 3×3 mm and 6×6 mm macular scan size. The biggest difference of VD between the two scan size was 5.14±4.03, which was not clinically meaningful. No statistically significant differences were found in FAZ or CCVD between the two different scan sizes. The mean intraclass correlation coefficient (ICC) between two measurements from the inter-rater of 20 eyes was from 0.560 to 0.893 for VD and 0.845 for FAZ. The mean ICC between two measurements from the intrarater of 20 eyes was from 0.497 to 0.870 for VD and 0.780 for FAZ. Conclusions FAZ and CCVD are interchangeable between the 3×3 mm and 6×6 mm macular scan sizes. The VD differences between the two different scan sizes are not clinically meaningful. The macular perfusion parameters presented good but not perfect reliability, which should be acknowledged in clinical practice. PMID:28336674

  2. Appositional Closure Identified by Ultrasound Biomicroscopy in Population-Based Primary Angle-Closure Glaucoma Suspects: The Liwan Eye Study

    PubMed Central

    Kong, Xiangbin; Foster, Paul J.; Huang, Qunxiao; Zheng, Yingfeng; Huang, Wenyong; Cai, Xiaoyu

    2011-01-01

    Purpose. To describe the characteristics of the iridocorneal angle using ultrasound biomicroscopy (UBM) in Chinese people classified gonioscopically as having suspected primary angle-closure (PACS) glaucoma. Methods. PACS were defined as not having visible posterior (usually pigmented) trabecular meshwork in two or more quadrants examined by static gonioscopy. The PACS and 1 of 10 those who did not meet this criterion were identified from a population-based survey. Iridotrabecular meshwork contact (ITC) was identified and further classified into low and high, according to standard UBM images. Those with high ITC were further classified according the configuration of ITC: B-type, with contiguous ITC from the base of the angle, and S-type, with ITC localized to the region of Schwalbe's line. Results. ITC was identified in 78.6% of the superior, 40.2% of the nasal, 59.8% of the inferior, and 25.6% of the temporal quadrants in the PACS (n = 117). These proportions were 43.9%, 15.8%, 29.8%, and 14.0% in the controls (n = 57), respectively. About two thirds of the eyes with ITC were classified as high. In those with high ITC, the number with B- and S-type ITC was very similar. The proportions of any high ITCs increased substantially from 15.4% in those with Shaffer angle grade 4 and 45.0% in grade 3, to 71.0% in grade 2, 70.2% in grade 1, and 86.4% in grade 0. Conclusions. More ITC is identified on UBM imaging than by gonioscopy. Careful consideration should be given to the assessment modality regarded as the reference standard in defining anatomic risk factors for glaucomatous visual loss and the need for treatment. PMID:21357394

  3. Middle Ear Mechanics of Cartilage Tympanoplasty Evaluated by Laser Holography and Vibrometry

    PubMed Central

    Aarnisalo, Antti A.; Cheng, Jeffrey T.; Ravicz, Michael E.; Hulli, Nesim; Harrington, Ellery J.; Hernandez-Montes, Maria S.; Furlong, Cosme; Merchant, Saumil N.; Rosowski, John J.

    2010-01-01

    Goals To assess the effects of thickness and position of cartilage used to reconstruct the tympanic membrane (TM) using a novel technique, time-averaged laser holography. Background Cartilage is commonly used in TM reconstruction to prevent formation of retraction pockets. The thickness, position, and shape of the cartilage graft may adversely affect TM motion and hearing. We sought to systematically investigate these parameters in an experimental setting. Methods Computer-assisted optoelectronic laser holography was used in 4 human cadaveric temporal bones to study sound-induced TM motion for 500 Hz to 8 kHz. Stapes velocity was measured with a laser Doppler vibrometer. Baseline (control) measurements were made with the TM intact. Measurements were repeated after a 0.5- or 1.0-mm-thick oval piece of conchal cartilage was placed on the medial TM surface in the posterior-superior quadrant. The cartilage was rotated so that it was either in contact with the bony tympanic rim and manubrium or not. Results At frequencies less than 4 kHz, the cartilage graft had only minor effects on the overall TM fringe patterns. The different conditions had no effects on stapes velocity. Greater than 4 kHz, TM motion was reduced over the grafted TM, both with 0.5- and 1.0-mm-thick grafts. No significant differences in stapes velocity were seen with the 2 different thicknesses of cartilage compared with control. Conclusion Computer-assisted optoelectronic laser holography is a promising technique to investigate middle ear mechanics after tympanoplasty. Such positioning may prevent postoperative TM retraction. These findings and conclusions apply to cartilage placed in the posterior-superior TM quadrant. PMID:19779389

  4. Autosomal Recessive Retinitis Pigmentosa Caused by Mutations in the MAK Gene

    PubMed Central

    Luo, Xunda; Héon, Elise; Lam, Byron L.; Weleber, Richard G.; Halder, Jennifer A.; Affatigato, Louisa M.; Goldberg, Jacqueline B.; Sumaroka, Alexander; Schwartz, Sharon B.; Cideciyan, Artur V.; Jacobson, Samuel G.

    2011-01-01

    Purpose. To determine the disease expression in autosomal recessive (ar) retinitis pigmentosa (RP) caused by mutations in the MAK (male germ cell-associated kinase) gene. Methods. Patients with RP and MAK gene mutations (n = 24; age, 32–77 years at first visit) were studied by ocular examination, perimetry, and optical coherence tomography (OCT). Results. All but one MAK patient were homozygous for an identical truncating mutation in exon 9 and had Ashkenazi Jewish heritage. The carrier frequency of this mutation among 1207 unrelated Ashkenazi control subjects was 1 in 55, making it the most common cause of heritable retinal disease in this population and MAK-associated RP the sixth most common Mendelian disease overall in this group. Visual acuities could be normal into the eighth decade of life. Kinetic fields showed early loss in the superior–temporal quadrant. With more advanced disease, superior and midperipheral function was lost, but the nasal field remained. Only a central island was present at late stages. Pigmentary retinopathy was less prominent in the superior nasal quadrant. Rod-mediated vision was abnormal but detectable in the residual field; all patients had rod>cone dysfunction. Photoreceptor layer thickness was normal centrally but decreased with eccentricity. At the stages studied, there was no evidence of photoreceptor ciliary elongation. Conclusions. The patterns of disease expression in the MAK form of arRP showed some resemblance to patterns described in autosomal dominant RP, especially the form caused by RP1 mutations. The similarity in phenotypes is of interest, considering that there is experimental evidence of interaction between Mak and RP1 in the photoreceptor cilium. PMID:22110072

  5. Analysis of the Retinal Nerve Fiber Layer Thickness in Alzheimer Disease and Mild Cognitive Impairment.

    PubMed

    Kwon, Jin Young; Yang, Ji Ho; Han, Ji Sang; Kim, Do Gyun

    2017-12-01

    To compare the retinal nerve fiber layer (RNFL) as well as the macula volume and thickness in the eyes of age-matched healthy controls with no cognitive disabilities with those of elderly people with mild cognitive impairment (MCI) or Alzheimer disease (AD). We used optical coherence tomography (OCT) to determine the effectiveness of the above quantities for early diagnosis of MCI or AD. Ninety eyes were considered in this study, split between 30 normal eyes, 30 eyes from patients with MCI, and 30eyes from patients with AD. All subjects underwent ophthalmologic and cognitive examinations, and measurements of the RNFL thickness as well as macular volume and thickness were taken for all patients using OCT. The mean RNFL thickness upon OCT was significantly thinner in the AD group than in the MCI group (p = 0.01). The RNFL was thinner in the superior quadrant in patients with AD when compared to the healthy controls (p = 0.03). The RNFL thicknesses in the inferior, nasal, and temporal quadrants did not differ significantly between the groups. Measurements in the 12 clock-hour zones revealed that zone 11 had a significantly thinner RNFL in the AD group as compared with the healthy control group (p = 0.02). In zone 2, the MCI group had a significantly thinner RNFL than the AD group (p = 0.03). Our OCT findings revealed a neuroanatomic difference in the RNFL thickness among the three groups, i.e., the AD, MCI, and healthy control groups. This suggests that a change in average RNFL thickness could be a meaningful index for diagnosing early AD. © 2017 The Korean Ophthalmological Society

  6. A preliminary riparian/wetland vegetation community classification of the Upper and Middle Rio Grande watersheds in New Mexico

    Treesearch

    Paula Durkin; Esteban Muldavin; Mike Bradley; Stacey E. Carr

    1996-01-01

    The riparian wetland vegetation communities of the upper and middle Rio Grande watersheds in New Mexico were surveyed in 1992 through 1994. The communities are hierarchically classified in terms of species composition and vegetation structure. The resulting Community Types are related to soil conditions, hydrological regime, and temporal dynamics. The classification is...

  7. Partial Correlation-Based Retinotopically Organized Resting-State Functional Connectivity Within and Between Areas of the Visual Cortex Reflects More Than Cortical Distance

    PubMed Central

    Dawson, Debra Ann; Lam, Jack; Lewis, Lindsay B.; Carbonell, Felix; Mendola, Janine D.

    2016-01-01

    Abstract Numerous studies have demonstrated functional magnetic resonance imaging (fMRI)-based resting-state functional connectivity (RSFC) between cortical areas. Recent evidence suggests that synchronous fluctuations in blood oxygenation level-dependent fMRI reflect functional organization at a scale finer than that of visual areas. In this study, we investigated whether RSFCs within and between lower visual areas are retinotopically organized and whether retinotopically organized RSFC merely reflects cortical distance. Subjects underwent retinotopic mapping and separately resting-state fMRI. Visual areas V1, V2, and V3, were subdivided into regions of interest (ROIs) according to quadrants and visual field eccentricity. Functional connectivity (FC) was computed based on Pearson's linear correlation (correlation), and Pearson's linear partial correlation (correlation between two time courses after the time courses from all other regions in the network are regressed out). Within a quadrant, within visual areas, all correlation and nearly all partial correlation FC measures showed statistical significance. Consistently in V1, V2, and to a lesser extent in V3, correlation decreased with increasing eccentricity separation. Consistent with previously reported monkey anatomical connectivity, correlation/partial correlation values between regions from adjacent areas (V1-V2 and V2-V3) were higher than those between nonadjacent areas (V1-V3). Within a quadrant, partial correlation showed consistent significance between regions from two different areas with the same or adjacent eccentricities. Pairs of ROIs with similar eccentricity showed higher correlation/partial correlation than pairs distant in eccentricity. Between dorsal and ventral quadrants, partial correlation between common and adjacent eccentricity regions within a visual area showed statistical significance; this extended to more distant eccentricity regions in V1. Within and between quadrants, correlation decreased approximately linearly with increasing distances separating the tested ROIs. Partial correlation showed a more complex dependence on cortical distance: it decreased exponentially with increasing distance within a quadrant, but was best fit by a quadratic function between quadrants. We conclude that RSFCs within and between lower visual areas are retinotopically organized. Correlation-based FC is nonselectively high across lower visual areas, even between regions that do not share direct anatomical connections. The mechanisms likely involve network effects caused by the dense anatomical connectivity within this network and projections from higher visual areas. FC based on partial correlation, which minimizes network effects, follows expectations based on direct anatomical connections in the monkey visual cortex better than correlation. Last, partial correlation-based retinotopically organized RSFC reflects more than cortical distance effects. PMID:26415043

  8. Ground-Support Algorithms for Simulation, Processing, and Calibration of Barnes Static Earth Sensor Measurements: Applications to Tropical Rainfall Measuring Mission Observatory

    NASA Technical Reports Server (NTRS)

    Natanson, G. A.

    1997-01-01

    New algorithms are described covering the simulation, processing, and calibration of penetration angles of the Barnes static Earth sensor assembly (SESA) as implemented in the Goddard Space Flight Center Flight Dynamics Division ground support system for the Tropical Rainfall Measuring Mission (TRMM) Observatory. The new treatment involves a detailed analysis of the measurements by individual quadrants. It is shown that, to a good approximation, individual quadrant misalignments can be treated simply as penetration angle biases. Simple formulas suitable for real-time applications are introduced for computing quadrant-dependent effects. The simulator generates penetration angles by solving a quadratic equation with coefficients uniquely determined by the spacecraft's position and the quadrant's orientation in GeoCentric Inertial (GCI) coordinates. Measurement processing for attitude determination is based on linearized equations obtained by expanding the coefficients of the aforementioned quadratic equation as a Taylor series in both the Earth oblateness coefficient (alpha approx. 1/150) and the angle between the pointing axis and the geodetic nadir vector. A simple formula relating a measured value of the penetration angle to the deviation of the Earth-pointed axis from the geodetic nadir vector is derived. It is shown that even near the very edge of the quadrant's Field Of View (FOV), attitude errors resulting from quadratic effects are a few hundredths of a degree, which is small compared to the attitude determination accuracy requirement (0.18 degree, 3 sigma) of TRMM. Calibration of SESA measurements is complicated by a first-order filtering used in the TRMM onboard algorithm to compute penetration angles from raw voltages. A simple calibration scheme is introduced where these complications are avoided by treating penetration angles as the primary raw measurements, which are adjusted using biases and scale factors. In addition to three misalignment parameters, the calibration state vector contains only two average penetration angle biases (one per each pair of opposite quadrants) since, because of the very narrow sensor FOV (+/- 2.6 degrees), differences between biases of the penetration angles measured by opposite quadrants cannot be distinguished from roll and pitch sensor misalignments. After calibration, the estimated misalignments and average penetration angle biases are converted to the four penetration angle biases and to the yaw misalignment angle. The resultant biases and the estimated scale factors are finally used to update the coefficients necessary for onboard computations of penetration angles from measured voltages.

  9. Partial Correlation-Based Retinotopically Organized Resting-State Functional Connectivity Within and Between Areas of the Visual Cortex Reflects More Than Cortical Distance.

    PubMed

    Dawson, Debra Ann; Lam, Jack; Lewis, Lindsay B; Carbonell, Felix; Mendola, Janine D; Shmuel, Amir

    2016-02-01

    Numerous studies have demonstrated functional magnetic resonance imaging (fMRI)-based resting-state functional connectivity (RSFC) between cortical areas. Recent evidence suggests that synchronous fluctuations in blood oxygenation level-dependent fMRI reflect functional organization at a scale finer than that of visual areas. In this study, we investigated whether RSFCs within and between lower visual areas are retinotopically organized and whether retinotopically organized RSFC merely reflects cortical distance. Subjects underwent retinotopic mapping and separately resting-state fMRI. Visual areas V1, V2, and V3, were subdivided into regions of interest (ROIs) according to quadrants and visual field eccentricity. Functional connectivity (FC) was computed based on Pearson's linear correlation (correlation), and Pearson's linear partial correlation (correlation between two time courses after the time courses from all other regions in the network are regressed out). Within a quadrant, within visual areas, all correlation and nearly all partial correlation FC measures showed statistical significance. Consistently in V1, V2, and to a lesser extent in V3, correlation decreased with increasing eccentricity separation. Consistent with previously reported monkey anatomical connectivity, correlation/partial correlation values between regions from adjacent areas (V1-V2 and V2-V3) were higher than those between nonadjacent areas (V1-V3). Within a quadrant, partial correlation showed consistent significance between regions from two different areas with the same or adjacent eccentricities. Pairs of ROIs with similar eccentricity showed higher correlation/partial correlation than pairs distant in eccentricity. Between dorsal and ventral quadrants, partial correlation between common and adjacent eccentricity regions within a visual area showed statistical significance; this extended to more distant eccentricity regions in V1. Within and between quadrants, correlation decreased approximately linearly with increasing distances separating the tested ROIs. Partial correlation showed a more complex dependence on cortical distance: it decreased exponentially with increasing distance within a quadrant, but was best fit by a quadratic function between quadrants. We conclude that RSFCs within and between lower visual areas are retinotopically organized. Correlation-based FC is nonselectively high across lower visual areas, even between regions that do not share direct anatomical connections. The mechanisms likely involve network effects caused by the dense anatomical connectivity within this network and projections from higher visual areas. FC based on partial correlation, which minimizes network effects, follows expectations based on direct anatomical connections in the monkey visual cortex better than correlation. Last, partial correlation-based retinotopically organized RSFC reflects more than cortical distance effects.

  10. Relationship of the Van Herick Grading System with Peripheral Iris Configuration and Level of Iris Insertion.

    PubMed

    Khan, Faisal Aziz; Niazi, Shafaq Pervez Khan; Khan, Assad Zaman

    2017-09-01

    To determine the relationship of the van Herick angle grading system with the level of iris insertion and peripheral iris configuration. Observational study. Eye department, Combined Military Hospital, Malir Cantt., Karachi, from May to October 2015. Sixty-five eyes of 65 patients were recruited. Anterior chamber depth at the temporal limbus was measured as a fraction of corneal section thickness using van Herick technique and graded on the standard 4-point scale of the van Herick grading system. Gonioscopy of the temporal quadrant was performed with a Posner 4 mirror goniolens and both the true level of iris insertion and peripheral iris configuration were recorded on a 4-point scale so as to equate with the van Herick 4-point grading system. Spearman's rho test was applied to determine the relationship of the van Herick grading system with level of iris root insertion and peripheral iris configuration. Amoderate positive correlation between van Herick grade and peripheral iris configuration was found which was statistically significant (rs=0.42, p < 0.001). Astatistically significant and moderate positive correlation was also detected between van Herick grade and the level of iris insertion (rs=0.45, p < 0.001). The van Herick grade has a moderately positive relationship with the peripheral iris configuration and true level of iris insertion.

  11. Solid State Research

    DTIC Science & Technology

    1990-05-15

    reference to indicate the exact time of the transmitted pulse. The returned pulses are detected using a four - quadrant photomultiplie tube, and each quadrant ...1990) Nondegencrate Four -Wave Mixing K.B. Nichols DTIC AD-A221419 in AlGaAs Waveguides W.D. Goodhue Wafer Fusion: A Novel Technique Z.L. Liau Appl...Annealing H.J. Zeiger (1990) of Etched Compound Semiconductor Structures: Theoretical Modeling and Experimental Confirmation Programmable, Four -Channel

  12. ETR, TRA642. BASEMENT SPACE ALLOCATION FOR EXPERIMENTERS CA. 1966, SOUTHEAST ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    ETR, TRA-642. BASEMENT SPACE ALLOCATION FOR EXPERIMENTERS CA. 1966, SOUTHEAST QUADRANT OF FLOOR. WESTINGHOUSE ATOMIC POWER DIVISION (WAPD) AND BETTIS ATOMIC POWER LABORATORY (BAPL) CONSUME MOST OF THE QUADRANT. PHILLIPS PETROLEUM COMPANY ETR-E-2256, 12/1966. INL INDEX NO. 532-0642-00-706-021256, REV. F. - Idaho National Engineering Laboratory, Test Reactor Area, Materials & Engineering Test Reactors, Scoville, Butte County, ID

  13. Investigating a Quadrant Surface Coil Array for NQR Remote Sensing

    DTIC Science & Technology

    2014-10-23

    UNCLASSIFIED 1  Abstract—this paper is on the design and fabrication of a surface coil array in a quadrant layout for NQR (Nuclear Quadrupole...coupling and SNR (Signal-to-Noise Ratio) at standoff distances perpendicular from each coil. Index Terms— Nuclear Quadrupole Resonance, NQR ...Coil Array, probe, Nuclear Magnetic Resonance, tuning, decoupling, RLC, mutual coupling, RLC I. INTRODUCTION N Nuclear quadrupole resonance ( NQR

  14. Partial-mouth periodontal examination protocols for the determination of the prevalence and extent of gingival bleeding in adolescents.

    PubMed

    Machado, Michely Ediani; Tomazoni, Fernanda; Casarin, Maísa; Ardenghi, Thiago M; Zanatta, Fabricio Batistin

    2017-10-01

    To compare the performance of partial-mouth periodontal examination (PMPE) protocols with different cut-off points to the full-mouth examination (FME) in the assessment of the prevalence and extent of gingival bleeding in adolescents. A cross-sectional study was conducted involving 12-year-old adolescents. Following a systematic two-stage cluster sampling process, 1134 individuals were evaluated. Different PMPE protocols were compared to the FME with six sites per tooth. Sensitivity, specificity, area under the ROC curve (AUC), intraclass correlation coefficient (ICC), relative and absolute biases and the inflation factor were assessed for each PMPE protocol with different cut-off points for the severity of gingival bleeding. The highest AUC values were found for the six-site two-diagonal quadrant (2-4) (0.97), six-site random half-mouth (0.95) and Community Periodontal Index (0.95) protocols. The assessment of three sites [mesiobuccal (MB), buccal (B) and distolingual (DL)] in two diagonal quadrants and the random half-mouth protocol had higher sensitivity and lower specificity than the same protocols with distobuccal (DB) sites. However, the use of DB sites led to better specificity and improved the balance between sensitivity and specificity, except for the two-diagonal quadrant (1-3) protocol. The ≥1 cut-off point led to the most discrepant results from the FME. Six-site two-diagonal quadrant (2-4) and random half-mouth assessments perform better in the evaluation of gingival bleeding in adolescents. However, when a faster protocol is needed, a two-diagonal quadrant assessment using only MB, B and DL sites can be used with no important loss of information. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Two-speed phacoemulsification for soft cataracts using optimized parameters and procedure step toolbar with the CENTURION Vision System and Balanced Tip.

    PubMed

    Davison, James A

    2015-01-01

    To present a cause of posterior capsule aspiration and a technique using optimized parameters to prevent it from happening when operating soft cataracts. A prospective list of posterior capsule aspiration cases was kept over 4,062 consecutive cases operated with the Alcon CENTURION machine and Balanced Tip. Video analysis of one case of posterior capsule aspiration was accomplished. A surgical technique was developed using empirically derived machine parameters and customized setting-selection procedure step toolbar to reduce the pace of aspiration of soft nuclear quadrants in order to prevent capsule aspiration. Two cases out of 3,238 experienced posterior capsule aspiration before use of the soft quadrant technique. Video analysis showed an attractive vortex effect with capsule aspiration occurring in 1/5 of a second. A soft quadrant removal setting was empirically derived which had a slower pace and seemed more controlled with no capsule aspiration occurring in the subsequent 824 cases. The setting featured simultaneous linear control from zero to preset maximums for: aspiration flow, 20 mL/min; and vacuum, 400 mmHg, with the addition of torsional tip amplitude up to 20% after the fluidic maximums were achieved. A new setting selection procedure step toolbar was created to increase intraoperative flexibility by providing instantaneous shifting between the soft and normal settings. A technique incorporating a reduced pace for soft quadrant acquisition and aspiration can be accomplished through the use of a dedicated setting of integrated machine parameters. Toolbar placement of the procedure button next to the normal setting procedure button provides the opportunity to instantaneously alternate between the two settings. Simultaneous surgeon control over vacuum, aspiration flow, and torsional tip motion may make removal of soft nuclear quadrants more efficient and safer.

  16. Imaging of the iridocorneal angle with the RTVue spectral domain optical coherence tomography.

    PubMed

    Perera, Shamira A; Ho, Ching Lin; Aung, Tin; Baskaran, Mani; Ho, Henrietta; Tun, Tin A; Lee, Tian Loon; Kumar, Rajesh S

    2012-04-02

    To determine the ability of the RTVue spectral domain optical coherence tomography (SDOCT) to image the anterior chamber angle (ACA). Consecutive subjects, recruited from glaucoma clinics, prospectively underwent ophthalmic evaluation including gonioscopy by an ophthalmologist and anterior chamber imaging with SDOCT, adapted with a corneal lens adapter (cornea anterior module-low magnification [CAM-L]) and anterior segment OCT (ASOCT), both performed by a technician. Two different ophthalmologists, masked to gonioscopy findings, assessed visualization of the scleral spur (SS), Schwalbe's line (SL), and trabecular meshwork (TM) by the two modalities. The ability to detect a closed angle was compared with gonioscopy. The average age (SD) of the 81 subjects enrolled was 64.1 (11.4) years; the majority were Chinese (91.4%) and female (61.7%). SDOCT images revealed the SS in 26.9% (56/324) of quadrants and the SL in 44.1% (143/324) of quadrants; in ASOCT images, the SS could be visualized in 69.1% (224/324) of quadrants (P < 0.0001), but the SL was undetectable. The TM was detected equally well (17.3%, P < 0.92) using either device. The angle status was gradable in only 41.7% images with SDOCT, compared with 71.3% of ASOCT images (P < 0.0001). ACA was classified as closed in 19.3% of quadrants (26/135) with SDOCT images and in 44.2% (102/231) with ASOCT images compared with 37.7% (122/324) on gonioscopy. When analyzing the horizontal quadrants only, both modalities agreed well with gonioscopy, 0.75 and 0.74, respectively (AC1 statistics). The RTVue SDOCT allowed visualization of SL, TM, and SS. However, these landmarks were not detected in a large percentage of images.

  17. Evaluation of blotchy pigments in the anterior chamber angle as a sign of angle closure

    PubMed Central

    Rao, Harsha L; Mungale, Sachin C; Kumbar, Tukaram; Parikh, Rajul S; Garudadri, Chandra S

    2012-01-01

    Background: Blotchy pigments in the anterior chamber (AC) angle are considered diagnostic of primary angle closure (PAC). But there are no reports either on the prevalence of blotchy pigments in AC angles or the validity of this sign. Aims: To determine the prevalence of blotchy pigments in AC angles and to evaluate their relationship with glaucomatous optic neuropathy (GON) in eyes with occludable angles. Setting and Design: Cross-sectional, comparative study. Materials and Methods: Gonioscopy was performed in 1001 eyes of 526 subjects (245 eyes of 148 consecutive, occludable angle subjects and 756 eyes of 378 non-consecutive, open angle subjects), above 35 years of age. Quadrant-wise location of blotchy pigments was documented. Statistical Analysis: Odds of blotchy pigments in occludable angles against that in open angles were evaluated. Relationship of GON with blotchy pigments in occludable angle eyes was evaluated using a multivariate model. Results: Prevalence of blotchy pigments in occludable angles was 28.6% (95% CI, 22.9-34.3) and in open angles was 4.7% (95% CI, 3.2-6.3). Blotchy pigments were more frequently seen in inferior (16%) and superior quadrants (15%) of occludable angles, and inferior quadrant of open angles (4%). Odds of superior quadrant blotchy pigments in occludable angles were 33 times that in open angles. GON was seen in 107 occludable angle eyes. Blotchy pigments were not significantly associated with GON (odds ratio = 0.5; P = 0.1). Conclusions: Blotchy pigments were seen in 28.6% of occludable angle eyes and 4.7% of open angles eyes. Presence of blotchy pigments in the superior quadrant is more common in occludable angles. Presence of GON in occludable angle eyes was not associated with blotchy pigments. PMID:23202393

  18. Prevailing surface winds in Northern Serbia in the recent and past time periods; modern- and past dust deposition

    NASA Astrophysics Data System (ADS)

    Gavrilov, Milivoj B.; Marković, Slobodan B.; Schaetzl, Randall J.; Tošić, Ivana; Zeeden, Christian; Obreht, Igor; Sipos, György; Ruman, Albert; Putniković, Suzana; Emunds, Kathrin; Perić, Zoran; Hambach, Ulrich; Lehmkuhl, Frank

    2018-04-01

    This study utilizes four different methodological approaches to examine the prevailing surface winds and their associated aeolian processes in Northern Serbia, focusing on the southeastern part of the Carpathian Basin. We utilized wind and atmospheric pressure data from 1939-2014 and 1960-2010 for the climatological analyses. Geomorphological data and numerical simulations were used to estimate prevailing paleowind systems. Northern Serbia is currently dominated by surface winds coming from the fourth (270°-360°) and second (90°-180°) quadrants, with frequencies of ca. 116 and 105 days/year, respectively. Comparable frequencies within Banatska Peščara are 115 and 129 days/year, respectively. Crestal orientations of the vast majority of the ≈1300 parabolic dunes here suggest that they have formed from winds derived from the second quadrant, indicating formation during the early Holocene. The remaining dunes, of the transverse type, have orientations aligned to the third quadrant. Grain size analysis of loess deposits near Banatska Peščara points to deposition driven by southeasterly winds, probably during the period between the Last Glacial Maximum (LGM) and the early Holocene. Modern wind measurements and geomorphological data showed that the prevailing winds in the recent and past periods were from the same quadrant, in and around Banatska Peščara. These results were confirmed with an explicit numerical simulation that modelled prevailing winds from the second quadrant during the LGM. Thus, the various geomorphologic and climatic data analyzed in this study show that the general air circulation patterns in the recent period are not dissimilar to those operative during the LGM.

  19. Venous beading in two or more quadrants might not be a sensitive grading criterion for severe nonproliferative diabetic retinopathy.

    PubMed

    Chen, Ling; Zhang, Xiongze; Wen, Feng

    2018-06-01

    To determine whether venous beading (VB) in two or more quadrants is an appropriate grading criterion for severe nonproliferative diabetic retinopathy (NPDR). A hospital-based, retrospective, cross-sectional study. A total of 806 patients admitted with diabetic retinopathy (DR) from January 2014 to April 2017 were included in this study. DR severity was graded by the international grading criterion. The status of VB, intraretinal microvascular abnormalities (IRMA), capillary nonperfusion, arteriovenous nicking, and diabetic macular edema was evaluated based on fundus fluorescein angiography. The prevalence of VB in eyes with proliferative diabetic retinopathy (PDR), severe NPDR, and moderate NPDR was 41.3% (327/791), 5.9% (31/526), and 0% (0/295), respectively (p < 0.001). Moreover, the proportion of VB in two or more quadrants was even lower (27.1% for PDR and 2.1% for severe NPDR, p < 0.001), and among the total of 225 eyes with VB in two or more quadrants, 214 eyes (95.1%) were graded as PDR. Furthermore, VB formation was significantly correlated with capillary nonperfusion, duration of diabetes (both p < 0.001), and smoking (p < 0.05). After adjusting for age, sex, and other possible factors, VB (OR = 7.479, p < 0.001) and IRMA (OR = 2.433, p < 0.001) were determined as independent risk factors for developing PDR. Our study suggested that VB in two or more quadrants might not be a sensitive grading criterion for severe NPDR among a Chinese population with type 2 diabetes. Nevertheless, VB has a great specificity to define an advanced form of DR.

  20. Minor psychiatric disorders among nurses university faculties.

    PubMed

    Tavares, Juliana Petri; Beck, Carmem Lúcia Colomé; Magnago, Tânia Solange Bosi de Souza; Zanini, Roselaine Ruviaro; Lautert, Liana

    2012-01-01

    This cross-sectional study addresses 130 nursing faculty members in federal universities from Rio Grande do Sul, Brazil. It investigated the psychological demands and decision latitude (the Demand-Control Model by Karasek) and their association with Minor Psychological Disorders (MPDs). The Brazilian versions of the Self-Report-Questionnaire-20 and the Job Stress Scale were used. MPDs were prevalent in 20% of the studied individuals. After adjusting for potential confounders, the chances of participants presenting mental disorders were higher in the quadrant 'active strain jobs' (OR=14.23, 95% CI 1.55 to 130.73), followed by the 'high strain jobs' quadrant (OR=10.05, 95% CI 1.23 to 82.44), compared to nursing professors classified in the 'low strain jobs' quadrant. We conclude that high psychological demands and low control over work can cause disorders in nursing professors, among them, MPDs.

  1. First saccadic eye movement reveals persistent attentional guidance by implicit learning

    PubMed Central

    Jiang, Yuhong V.; Won, Bo-Yeong; Swallow, Khena M.

    2014-01-01

    Implicit learning about where a visual search target is likely to appear often speeds up search. However, whether implicit learning guides spatial attention or affects post-search decisional processes remains controversial. Using eye tracking, this study provides compelling evidence that implicit learning guides attention. In a training phase, participants often found the target in a high-frequency, “rich” quadrant of the display. When subsequently tested in a phase during which the target was randomly located, participants were twice as likely to direct the first saccadic eye movement to the previously rich quadrant than to any of the sparse quadrants. The attentional bias persisted for nearly 200 trials after training and was unabated by explicit instructions to distribute attention evenly. We propose that implicit learning guides spatial attention but in a qualitatively different manner than goal-driven attention. PMID:24512610

  2. Transforming Norwegian Special Operation Forces

    DTIC Science & Technology

    2006-06-01

    Justice and Police. This pertains to the Coast Guard maintaining 146 Ole M. Rapp, "Får Europas Beste Marine [the Best Navy in Europe]," Aftenposten...service affiliation. Both units collectively represent capabilities within quadrant 1 and 2 of Figure 15. This is the flexibility NORSOF is assumed...reference to SOF’s domain. However, if indirect action capabilities are required or desired within both quadrants 3 and 4, domain matters. The

  3. Suppression of the Near Wall Burst Process of a Fully Developed Turbulent Pipe Flow

    DTIC Science & Technology

    1993-05-01

    tunmel turbulent boundary layer a) velocity fluctuation skewness levels and b) velocity fluctuation kurtosis levels ...by the undisturbed total uv level and u*. a) quadrants I and 2 and b) quadrants 3 and 4 ...................... 105 5.20 Spanwise development of the uw...and radial velocity skewness levels . Normalization with ref. u". .............................. 111 xi 5.23 Spanwise development of profi!s of the

  4. Changes in serum interleukin-6, C-reactive protein and thrombomodulin levels under periodontal ultrasonic debridement.

    PubMed

    Ushida, Yuka; Koshy, Geena; Kawashima, Yoko; Kiji, Makoto; Umeda, Makoto; Nitta, Hiroshi; Nagasawa, Toshiyuki; Ishikawa, Isao; Izumi, Yuichi

    2008-11-01

    This study aimed to compare the effect of single-visit full-mouth mechanical debridement (FMD) and quadrant-wise mechanical debridement (QMD) on the levels of serum interleukin (IL)-6, C-reactive protein (CRP) and soluble thrombomodulin. Thirty-six subjects with chronic periodontitis were randomly allocated to three groups: undergoing QMD, single-visit FMD with povidone iodine or with water. Serum IL-6 and soluble thrombomodulin were measured by enzyme-linked immunosorbent assay, and serum CRP was measured by the latex-enhanced nephelometric method. Serum IL-6 level increased significantly immediately after debridement in all the three groups, with this increase being greatest in the full-mouth groups. However, the increase in the full-mouth groups was not significantly higher than that of quadrant-wise group. In the quadrant-wise group, serum IL-6 level decreased significantly 1 month after debridement compared with baseline. Serum-soluble thrombomodulin decreased significantly in the full-mouth groups but not in the quadrant-wise group. Changes in CRP level were not significant at baseline or after debridement in all the three groups. FMD increased serum IL-6 and reduced serum-soluble thrombomodulin to a greater extent than QMD, suggesting that the former technique has stronger transient effects on systemic vascular endothelial functions than the latter.

  5. Territorial organization of the lowland classic maya.

    PubMed

    Marcus, J

    1973-06-01

    Thus far I have discussed ancient Maya sociopolitical structure from the upper levels of the hierarchy downward. Let me now summarize their territorial organization from the bottom upward, starting at the hamlet level (Fig. 8). The smallest unit of settlement-one usually overlooked by archeological surveys in the lowland rain forest-was probably a cluster of thatched huts occupied by a group of related families; larger clusters may have been divided into four quadrants along the lines suggested by Coe (26). Because of the long fallow period (6 to 8 years) characteristic of slash-and-burn agriculture in the Petén, these small hamlets are presumed to have changed location over the years, although they probably shifted in a somewhat circular fashion around a tertiary ceremonial-civic center for whose maintenance they were partly responsible. These tertiary centers were spaced at fairly regular intervals around secondary ceremonial-civic centers with pyramids, carved monuments, and palace-like residences. In turn, the secondary centers occurred at such regular intervals as to form hexagonal patterns around primary centers, which were still larger, with acropolises, multiple ceremonial plazas, and greater numbers of monuments. In some cases, the distance between secondary centers was roughly twice the distance between secondary and tertiary centers, creating a lattice of nested hexagonal cells. This pattern, which conforms to a Western theoretical construct, was presumably caused by factors of service function, travel, and transport. The pattern was not recognized by the Maya at all. They simply recognized that a whole series of smaller centers were dependent on a primary center and therefore mentioned its emblem glyph. Linking the centers of the various hexagons were marriage alliances between members of royal dynasties, who had no kinship ties with the farmers in the hamlets. Out of the large number of primary centers available to them, the Maya selected four as regional capitals. True to their cosmology, the Maya regarded these capitals as associated with the four quadrants of their realm, regardless of their actual location. Each was the home city for a very important dynasty whose junior members probably ruled secondary centers. Since the hexagonal lattices were probably adjusted to variations in population density, each of the four quadrants of the Maya realm probably controlled a comparable number of persons. So strong was the cognized model that, despite the rise and fall of individual centers, there seem always to have been four capitals, each associated with a direction and, presumably, with a color. There is still a great deal to learn about the social, political, and territorial organization of the lowland Maya, and parts of the picture presented here need far more data for their confirmation. What seems likely is that the Maya had an overall quadripartite organization (rather than a core and buffer zone) and that within each quadrant there was at least a five-tiered administrative hierarchy of capital, secondary center, tertiary center, village, and hamlet. Perhaps most significant, there was no real conflict between the lattice-like network predicted by locational analysis and the cosmological four-part structure predicted by epigraphy and ethnology.

  6. Surface electromyography analysis of blepharoptosis correction by transconjunctival incisions.

    PubMed

    Tu, Lung-Chen; Wu, Ming-Chya; Chu, Hsueh-Liang; Chiang, Yi-Pin; Kuo, Chih-Lin; Li, Hsing-Yuan; Chang, Chia-Ching

    2016-06-01

    Upper eyelid movement depends on the antagonistic actions of orbicularis oculi muscle and levator aponeurosis. Blepharoptosis is an abnormal drooping of upper eyelid margin with the eye in primary position of gaze. Transconjunctival incisions for upper eyelid ptosis correction have been a well-developed technique. Conventional prognosis however depends on clinical observations and lacks of quantitatively analysis for the eyelid muscle controlling. This study examines the possibility of using the assessments of temporal correlation in surface electromyography (SEMG) as a quantitative description for the change of muscle controlling after operation. Eyelid SEMG was measured from patients with blepharoptosis preoperatively and postoperatively, as well as, for comparative study, from young and aged normal subjects. The data were analyzed using the detrended fluctuation analysis method. The results show that the temporal correlation of the SEMG signals can be characterized by two indices associated with the correlation properties in short and long time scales demarcated at 3ms, corresponding to the time scale of neural response. Aging causes degradation of the correlation properties at both time scales, and patient group likely possess more serious correlation degradation in long-time regime which was improved moderately by the ptosis corrections. We propose that the temporal correlation in SEMG signals may be regarded as an indicator for evaluating the performance of eyelid muscle controlling in postoperative recovery. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Variability in soil CO2 production and surface CO2 efflux across riparian-hillslope transitions

    Treesearch

    Vincent Jerald Pacific

    2007-01-01

    The spatial and temporal controls on soil CO2 production and surface CO2 efflux have been identified as an outstanding gap in our understanding of carbon cycling. I investigated both the spatial and temporal variability of soil CO2 concentrations and surface CO2 efflux across eight topographically distinct riparian-hillslope transitions in the ~300 ha subalpine upper-...

  8. Evaluation of the Leap Motion Controller during the performance of visually-guided upper limb movements.

    PubMed

    Niechwiej-Szwedo, Ewa; Gonzalez, David; Nouredanesh, Mina; Tung, James

    2018-01-01

    Kinematic analysis of upper limb reaching provides insight into the central nervous system control of movements. Until recently, kinematic examination of motor control has been limited to studies conducted in traditional research laboratories because motion capture equipment used for data collection is not easily portable and expensive. A recently developed markerless system, the Leap Motion Controller (LMC), is a portable and inexpensive tracking device that allows recording of 3D hand and finger position. The main goal of this study was to assess the concurrent reliability and validity of the LMC as compared to the Optotrak, a criterion-standard motion capture system, for measures of temporal accuracy and peak velocity during the performance of upper limb, visually-guided movements. In experiment 1, 14 participants executed aiming movements to visual targets presented on a computer monitor. Bland-Altman analysis was conducted to assess the validity and limits of agreement for measures of temporal accuracy (movement time, duration of deceleration interval), peak velocity, and spatial accuracy (endpoint accuracy). In addition, a one-sample t-test was used to test the hypothesis that the error difference between measures obtained from Optotrak and LMC is zero. In experiment 2, 15 participants performed a Fitts' type aiming task in order to assess whether the LMC is capable of assessing a well-known speed-accuracy trade-off relationship. Experiment 3 assessed the temporal coordination pattern during the performance of a sequence consisting of a reaching, grasping, and placement task in 15 participants. Results from the t-test showed that the error difference in temporal measures was significantly different from zero. Based on the results from the 3 experiments, the average temporal error in movement time was 40±44 ms, and the error in peak velocity was 0.024±0.103 m/s. The limits of agreement between the LMC and Optotrak for spatial accuracy measures ranged between 2-5 cm. Although the LMC system is a low-cost, highly portable system, which could facilitate collection of kinematic data outside of the traditional laboratory settings, the temporal and spatial errors may limit the use of the device in some settings.

  9. Evaluation of the Leap Motion Controller during the performance of visually-guided upper limb movements

    PubMed Central

    Gonzalez, David; Nouredanesh, Mina; Tung, James

    2018-01-01

    Kinematic analysis of upper limb reaching provides insight into the central nervous system control of movements. Until recently, kinematic examination of motor control has been limited to studies conducted in traditional research laboratories because motion capture equipment used for data collection is not easily portable and expensive. A recently developed markerless system, the Leap Motion Controller (LMC), is a portable and inexpensive tracking device that allows recording of 3D hand and finger position. The main goal of this study was to assess the concurrent reliability and validity of the LMC as compared to the Optotrak, a criterion-standard motion capture system, for measures of temporal accuracy and peak velocity during the performance of upper limb, visually-guided movements. In experiment 1, 14 participants executed aiming movements to visual targets presented on a computer monitor. Bland-Altman analysis was conducted to assess the validity and limits of agreement for measures of temporal accuracy (movement time, duration of deceleration interval), peak velocity, and spatial accuracy (endpoint accuracy). In addition, a one-sample t-test was used to test the hypothesis that the error difference between measures obtained from Optotrak and LMC is zero. In experiment 2, 15 participants performed a Fitts’ type aiming task in order to assess whether the LMC is capable of assessing a well-known speed-accuracy trade-off relationship. Experiment 3 assessed the temporal coordination pattern during the performance of a sequence consisting of a reaching, grasping, and placement task in 15 participants. Results from the t-test showed that the error difference in temporal measures was significantly different from zero. Based on the results from the 3 experiments, the average temporal error in movement time was 40±44 ms, and the error in peak velocity was 0.024±0.103 m/s. The limits of agreement between the LMC and Optotrak for spatial accuracy measures ranged between 2–5 cm. Although the LMC system is a low-cost, highly portable system, which could facilitate collection of kinematic data outside of the traditional laboratory settings, the temporal and spatial errors may limit the use of the device in some settings. PMID:29529064

  10. Abrupt Upper-Plate Tilting Upon Slab-Transition-Zone Collision

    NASA Astrophysics Data System (ADS)

    Crameri, F.; Lithgow-Bertelloni, C. R.

    2017-12-01

    During its sinking, the remnant of a surface plate crosses and interacts with multiple boundaries in Earth's interior. The most-prominent dynamic interaction arises at the upper-mantle transition zone where the sinking plate is strongly affected by the higher-viscosity lower mantle. Within our numerical model, we unravel, for the first time, that this very collision of the sinking slab with the transition zone induces a sudden, dramatic downward tilt of the upper plate towards the subduction trench. The slab-transition zone collision sets parts of the higher-viscosity lower mantle in motion. Naturally, this then induces an overall larger return flow cell that, at its onset, tilts the upper plate abruptly by around 0.05 degrees and over around 10 Millions of years. Such a significant and abrupt variation in surface topography should be clearly visible in temporal geologic records of large-scale surface elevation and might explain continental-wide tilting as observed in Australia since the Eocene or North America during the Phanerozoic. Unravelling this crucial mantle-lithosphere interaction was possible thanks to state-of-the-art numerical modelling (powered by StagYY; Tackley 2008, PEPI) and post-processing (powered by StagLab; www.fabiocrameri.ch/software). The new model that is introduced here to study the dynamically self-consistent temporal evolution of subduction features accurate subduction-zone topography, robust single-sided plate sinking, stronger plates close to laboratory values, an upper-mantle phase transition and, crucially, simple continents at a free surface. A novel, fully-automated post-processing includes physical model diagnostics like slab geometry, mantle flow pattern, upper-plate tilt angle and trench location.

  11. Optimizing Performance of a Microwave Salinity Mapper: STARRS L-Band Radiometer Enhancements

    DTIC Science & Technology

    2007-05-04

    Contribution Number NRL/JA/ setts at Amherst, along with Quadrant Engineering Inc. 7330-05-5313. (now ProSensing Inc.) and funding from the National...Thus, sampling schemes development of STARRS by Quadrant Engineering can be optimized for particular applications. STARRS began under Naval Research...performance to be optimized. As we show later, a draw- ture, computed as the mean temperature from four back of this approach not found in analog

  12. [Generalization of the Lotka-Volterra equation].

    PubMed

    Nazarenko, V G

    1976-01-01

    A complete qualitative study of Lotka--Volterra model with cooperative interactions in the system predator-prey is carried out. The model is as follows: (see abstract). The character of all possible stationary states is investigated in the first quadrant of the phase plane of the model variables depending on the system parameters. It is shown that for the generalized model considered unstable and stable limit cycles only of the infinite amplitude are possible in the first quadrant.

  13. The relationship between the IMF B(y) and the distant tail (150-238 Re) lobe and plasmasheet B(y) fields

    NASA Technical Reports Server (NTRS)

    Tsurutani, B. T.; Smith, E. J.; Jones, D. E.; Lepping, R. P.; Sibeck, D. G.

    1984-01-01

    The relationships between the Solar Magnetospheric (SM) y-component of the interplanetary magnetic field (IMF) and the lobe and plasmasheet magnetic fields have been studied for the two ISEE-3 deep tail passes. It is found that for positive sector IMFs, 13 percent of the interplanetary magnetic field penetrates into the aberrated north-dawn and south-dusk lobe quadrants, and about the same amount in the north-dusk and south-dawn lobe quadrants for negative sector IMFs. For the above cases, field penetration is significantly less for opposite polarity IMFs. The former results are generally consistent with open magnetospheric models, but the latter (the lack of response in certain quadrants) are unexplained by theory at this time. If the magnitude of the plasmasheet B(y) fields are related to plasma pressure anisotropies, very small anisotropies of about 1.01 are expected.

  14. An alternative approach for modeling strength differential effect in sheet metals with symmetric yield functions

    NASA Astrophysics Data System (ADS)

    Kurukuri, Srihari; Worswick, Michael J.

    2013-12-01

    An alternative approach is proposed to utilize symmetric yield functions for modeling the tension-compression asymmetry commonly observed in hcp materials. In this work, the strength differential (SD) effect is modeled by choosing separate symmetric plane stress yield functions (for example, Barlat Yld 2000-2d) for the tension i.e., in the first quadrant of principal stress space, and compression i.e., third quadrant of principal stress space. In the second and fourth quadrants, the yield locus is constructed by adopting interpolating functions between uniaxial tensile and compressive stress states. In this work, different interpolating functions are chosen and the predictive capability of each approach is discussed. The main advantage of this proposed approach is that the yield locus parameters are deterministic and relatively easy to identify when compared to the Cazacu family of yield functions commonly used for modeling SD effect observed in hcp materials.

  15. Streamwise evolution of statistical events and the triple correlation in a model wind turbine array

    NASA Astrophysics Data System (ADS)

    Viestenz, Kyle; Cal, Raúl Bayoán

    2013-11-01

    Hot-wire anemometry data, obtained from a wind tunnel experiment containing a 3 × 3 wind turbine array, are used to conditionally average the Reynolds stresses. Nine profiles at the centerline behind the array are analyzed to characterize the turbulent velocity statistics of the wake flow. Quadrant analysis yields statistical events occurring in the wake of the wind farm, where quadrants 2 and 4 produce ejections and sweeps, respectively. A balance between these quadrants is expressed via the ΔSo parameter, which attains a maximum value at the bottom tip and changes sign near the top tip of the rotor. These are then associated to the triple correlation term present in the turbulent kinetic energy equation of the fluctuations. The development of these various quantities is assessed in light of wake remediation, energy transport and possess significance in closure models. National Science Foundation: ECCS-1032647.

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

    Aeloiza, Eddy C.; Burgos, Rolando P.

    A step-down AC/AC converter for use in an electric distribution system includes at least one chopper circuit for each one of a plurality of phases of the AC power, each chopper circuit including a four-quadrant switch coupled in series between primary and secondary sides of the chopper circuit and a current-bidirectional two-quadrant switch coupled between the secondary side of the chopper circuit and a common node. Each current-bidirectional two-quadrant switch is oriented in the same direction, with respect to the secondary side of the corresponding chopper circuit and the common node. The converter further includes a control circuit configured tomore » pulse-width-modulate control inputs of the switches, to convert a first multiphase AC voltage at the primary sides of the chopper circuits to a second multiphase AC voltage at the secondary sides of the chopper circuits, the second multiphase AC voltage being lower in voltage than the first multiphase AC voltage.« less

  17. Tracking Changes in Cardiac Output: Statistical Considerations on the 4-Quadrant Plot and the Polar Plot Methodology.

    PubMed

    Saugel, Bernd; Grothe, Oliver; Wagner, Julia Y

    2015-08-01

    When comparing 2 technologies for measuring hemodynamic parameters with regard to their ability to track changes, 2 graphical tools are omnipresent in the literature: the 4-quadrant plot and the polar plot recently proposed by Critchley et al. The polar plot is thought to be the more advanced statistical tool, but care should be taken when it comes to its interpretation. The polar plot excludes possibly important measurements from the data. The polar plot transforms the data nonlinearily, which may prevent it from being seen clearly. In this article, we compare the 4-quadrant and the polar plot in detail and thoroughly describe advantages and limitations of each. We also discuss pitfalls concerning the methods to prepare the researcher for the sound use of both methods. Finally, we briefly revisit the Bland-Altman plot for the use in this context.

  18. Negative ion source

    DOEpatents

    Delmore, James E.

    1987-01-01

    A method and apparatus for providing a negative ion source accelerates electrons away from a hot filament electron emitter into a region of crossed electric and magnetic fields arranged in a magnetron configuration. During a portion of the resulting cycloidal path, the electron velocity is reduced below its initial value. The electron accelerates as it leaves the surface at a rate of only slightly less than if there were no magnetic field, thereby preventing a charge buildup at the surface of the emitter. As the electron traverses the cycloid, it is decelerated during the second, third, and fourth quadrants, then reeccelerated as it approaches the end of the fourth quadrant to regain its original velocity. The minimum velocity occurs during the fourth quadrant, and corresponds to an electron temperature of 200.degree. to 500.degree. for the electric and magnetic fields commonly encountered in the ion sources of magnetic sector mass spectrometers. An ion source using the above-described thermalized electrons is also disclosed.

  19. Simultaneous detection of rotational and translational motion in optical tweezers by measurement of backscattered intensity.

    PubMed

    Roy, Basudev; Bera, Sudipta K; Banerjee, Ayan

    2014-06-01

    We describe a simple yet powerful technique of simultaneously measuring both translational and rotational motion of mesoscopic particles in optical tweezers by measuring the backscattered intensity on a quadrant photodiode (QPD). While the measurement of translational motion by taking the difference of the backscattered intensity incident on adjacent quadrants of a QPD is well known, we demonstrate that rotational motion can be measured very precisely by taking the difference between the diagonal quadrants. The latter measurement eliminates the translational component entirely and leads to a detection sensitivity of around 50 mdeg at S/N of 2 for angular motion of a driven microrod. The technique is also able to resolve the translational and rotational Brownian motion components of the microrod in an unperturbed trap and can be very useful in measuring translation-rotation coupling of micro-objects induced by hydrodynamic interactions.

  20. Abdominal perforation after rupture of a diamond-studded wire: a case report.

    PubMed

    Schmelzle, Moritz; Matthaei, Hanno; Tustas, Roy Y; Schmitt, Marcus; Müller-Mattheis, Volker; Linhart, Wolfgang; Eisenberger, Claus F; Knoefel, Wolfram T; Esch, Jan Schulte Am

    2008-11-13

    There are numerous cases of abdominal injuries due to bullets. Abdominal injuries due to bullets are a diagnostic and therapeutic challenge. Here, an unusual case of an abdominal perforation caused by a metal projectile, lead to confusion in the interpretation of the preoperative computer tomography. We present an unusual case of a 32-year-old male worker who sustained a "shot" to the left upper abdominal quadrant, as a result of a work-related accident. The projectile derived from a special wire that tore during operation. One chain element happened to accelerate towards the patients belly and perforated the abdominal wall. Computer tomography located the radiopaque projectile to the cortex of the left kidney and showed a lesion of the tail of the pancreas. The presence of intraperitoneal free air suggested a gastrointestinal perforation. Immediate open exploration of the peritoneal cavity and the retroperitoneal space revealed perforating lesions of the anterior and posterior gastric wall, as well as the pancreatic tail. The projectile was finally retrieved in the upper pole of the left kidney. The patient had a good clinical course subsequent to surgery and was discharged in good general condition. This case represents a rare form of a retained bullet injury and corroborates the need of sufficient measures of worker-protection in area of diamond-studded wire cutting devices.

  1. Ipsilateral breast metastasis from a pulmonary adenocarcinoma: a case report and a focused review of the literature

    PubMed Central

    Shen, Yan-Wei; Sui, Yan-Xia; Zhang, Xiao-Man; Lv, Meng; Zhang, Xiao; Liu, Pei-Jun; Yang, Jin

    2015-01-01

    Metastases to the breast from extramammary malignancies are extremely rare. Ruling out the diagnosis of primary breast tumor is important in order to decide on clinical management and predict prognosis. We report a case of metastasis to the breast from a pulmonary adenocarcinoma, with extensive micropapillary component, diagnosed concomitantly with the primary tumor. A 52 year-old female patient presented with mammary gland tingling and dyspnea accompanied with fatigued of 4 months duration and a nodular shadows in the front of the upper lobe was found on a chest computed tomography (CT) scan. The original clinical diagnosis was right breast cancer with lung and bone metastasis, or breast and lung double primary cancers. In addition,on physical examination a poorly defined mass was noted in the upper outer quadrant of the right breast. The patient underwent thoracocentesis and breast biopsy. By imageology, cytology, histology and immunohistochemistry, we diagnosed primary lung cancer with metastases to the right breast and bone. The metastatic anatomic sites demonstrated histologically extensive micropapillary component, which is recently recognized as an important prognostic factor. The patient was administered 4 cycles of cisplatin and docetaxel, although no clinical response was seen, the patient is still alive 9 months after diagnosis. The result of immunohistochemistry is a useful supplement in differential diagnosis. PMID:26464732

  2. The unexpected finding of a splenic infarction in a patient with infectious mononucleosis due to Epstein-Barr virus

    PubMed Central

    Machado, Catarina; Melo Salgado, Joana; Monjardino, Leonor

    2015-01-01

    The authors present a case of a 24-year-old man with infectious mononucleosis (IM) due to Epstein-Barr virus (EBV). Among his symptoms, he reported abdominal pain in the upper left quadrant. An abdominal ultrasound and CT revealed an extensive splenic infarction. During the acute stage of this disease, the thrombophilic screening revealed reduced free protein S and elevated factor VIII, with normalisation on re-evaluation 6 weeks later. Splenic infarction is a very rare complication of IM due to EBV but should be considered in patients presenting abdominal pain. A hypercoagulability state should be investigated. To our knowledge, this is the first described case of a splenic infarction in a patient with IM due to EBV associated with a transient reduction of protein S and elevation of factor VIII. Thus, this work promotes the importance of including these factors in the thrombophilic screening conducted during the investigation of similar cases. PMID:26607191

  3. Laparoscopic management of a translocated intrauterine device embedded in the gastric serosa.

    PubMed

    Bozkurt, Murat; Yumru, Ayse Ender; Coskun, Ebru Inci; Ondes, Banu

    2011-10-01

    Intrauterine devices (IUD) are the most common contraceptive methods all over the world. Besides many advantages, there are also some complications of this method. The most important complication of IUD is uterine perforation. The reported incidence of IUD perforation ranges from 0.2 to 9.6 per thousand insertions. In this article we would like to report a case that has an IUD migrated to the gastric serosa. A 41 years-old Turkish woman presented with abdominal pain. Plain X-ray of the abdomen demonstrated two IUDs, one in the upper quadrant of the abdomen, the other in the pelvic area and determined in the endometrium by TV-USG (transvaginal ultrasonography). Laparascopy was performed and the IUD, lying over the omentum of stomach was removed. This report demonstrates the first case in the literature that has an IUD embedded in the gastric serosa and also a second IUD in uterine cavity. The management was performed laparoscopically. No complication was observed during and after operation.

  4. Splenic cyst and its management in a 21-month-old boy: a rare complication of invasive meningococcal disease.

    PubMed

    Pratt, Jeremy John; Connell, Tom G; Bekhit, Elhamy; Crawford, Nigel W

    2018-05-04

    Splenic complications of invasive meningococcal disease (IMD) are well recognised, though cyst formation is rare, particularly in paediatric populations. The best approach to their management is not yet established. This case outlines the management of a splenic cyst in a 21-month-old boy following severe IMD. The case took place in the context of an acute emergence of serogroup W prompting significant media attention and subsequent change in vaccination practice at a jurisdictional level in Australia. The patient was critically unwell early in the illness, then later a collection in the left upper quadrant was detected, shown on ultrasound to be a 11.6×7.7 cm splenic cyst. In this case, the cyst was managed by ultrasound-guided drainage tube insertion. The residual collection was small and stable on subsequent imaging. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  5. Idiopath=ic Granulomatous Lobular Mastitis Masquerading as a Breast Tumor: A Case Report

    PubMed Central

    Raman R, Thulasi; Manimaran, D

    2016-01-01

    Introduction Idiopathic granulomatous lobular mastitis (IGLM) is an inflammatory disease of the breast with an obscure etiology. It occurs mainly in women of reproductive age, and the lesion mimics carcinoma of the breast both clinically and radiologically Case Presentation We present the case of a 29-year-old female who visited our hospital in Kancheepuram, Tamil Nadu, with a 4 × 3 cm lump in the upper outer quadrant of her left breast. The clinical and radiological findings were indicative of a malignant lesion; however, fine-needle aspiration cytology (FNAC) revealed features of granulomatous mastitis, and the subsequent histology of the excised lump confirmed the diagnosis of IGLM. Conclusions IGLM should be considered as one of the differential diagnoses when granulomas are encountered in breast FNAC and biopsy. A definitive diagnosis of IGLM can be made by identifying its characteristic histomorphology and ruling out other causes for granulomatous inflammation. An exact diagnosis is essential since the treatment for different granulomatous conditions of the breast varies. PMID:27437133

  6. Idiopath=ic Granulomatous Lobular Mastitis Masquerading as a Breast Tumor: A Case Report.

    PubMed

    Raman R, Thulasi; Manimaran, D

    2016-05-01

    Idiopathic granulomatous lobular mastitis (IGLM) is an inflammatory disease of the breast with an obscure etiology. It occurs mainly in women of reproductive age, and the lesion mimics carcinoma of the breast both clinically and radiologically. We present the case of a 29-year-old female who visited our hospital in Kancheepuram, Tamil Nadu, with a 4 × 3 cm lump in the upper outer quadrant of her left breast. The clinical and radiological findings were indicative of a malignant lesion; however, fine-needle aspiration cytology (FNAC) revealed features of granulomatous mastitis, and the subsequent histology of the excised lump confirmed the diagnosis of IGLM. IGLM should be considered as one of the differential diagnoses when granulomas are encountered in breast FNAC and biopsy. A definitive diagnosis of IGLM can be made by identifying its characteristic histomorphology and ruling out other causes for granulomatous inflammation. An exact diagnosis is essential since the treatment for different granulomatous conditions of the breast varies.

  7. Gamma-glutamyltranspeptidase to platelet ratio and albumin to gamma-glutamyltranspeptidase between degrees of the Barcelona clinic liver cancer on hepatocellular carcinoma patients in Haji Adam Malik general hospital Medan during 2015-2016

    NASA Astrophysics Data System (ADS)

    Siregar, G. A.; Siregar, R. H.

    2018-03-01

    Hepatocellular carcinoma (HCC) is a primary malignancy of the liver and occurs predominantly in apatient with underlying chronic liver disease and cirrhosis. HCC presented at an advancedstage with right-upper-quadrant pain, weight loss, and signs of decompensated liver disease; it is now increasingly recognized atmuch measurements of the biomarker. Some of them are Gamma-glutamyltranspeptidase to platelet ratio (GPR) and Albumin to Gamma- glutamyltranspeptidase (AGR). This study aimed to know the difference between GPR and AGR between degrees of the Barcelona Clinic Liver cancer (BCLC) on HCC patients. A retrospective study was carried out in 166 outpatient and inpatient HCC in Haji Adam Malik General Hospital from January 2015–December2016.Kruskal-Wallis test showed that there is no significant differentiation of GPR between degrees of BCLC (p=0.23), but there is a considerable differentiation of AGR between degrees of BCLC (p=0.032).

  8. The unexpected finding of a splenic infarction in a patient with infectious mononucleosis due to Epstein-Barr virus.

    PubMed

    Machado, Catarina; Melo Salgado, Joana; Monjardino, Leonor

    2015-11-25

    The authors present a case of a 24-year-old man with infectious mononucleosis (IM) due to Epstein-Barr virus (EBV). Among his symptoms, he reported abdominal pain in the upper left quadrant. An abdominal ultrasound and CT revealed an extensive splenic infarction. During the acute stage of this disease, the thrombophilic screening revealed reduced free protein S and elevated factor VIII, with normalisation on re-evaluation 6 weeks later. Splenic infarction is a very rare complication of IM due to EBV but should be considered in patients presenting abdominal pain. A hypercoagulability state should be investigated. To our knowledge, this is the first described case of a splenic infarction in a patient with IM due to EBV associated with a transient reduction of protein S and elevation of factor VIII. Thus, this work promotes the importance of including these factors in the thrombophilic screening conducted during the investigation of similar cases. 2015 BMJ Publishing Group Ltd.

  9. Southern Australia

    NASA Technical Reports Server (NTRS)

    2002-01-01

    South-central Australia is home to several deserts, including the Simpson Desert, whose reddish-orange sands are seen in the upper left quadrant of this Moderate Resolution Imaging Spectroradiometer (MODIS) image from July 1, 2002. Several impermanent, salty, lakes stand whitely out against the arid terrain. The largest is North Lake Eyre, southwest of center. At bottom center, Spencer Gulf separates the triangular Eyre Peninsula from the Yorke Peninsula. The Gulf of St. Vincent separates Yorke Peninsula from the mainland. In Spencer Gulf, colorful blue-green swirls indicate the presence of a bloom of marine plants called phytoplankton, whose brightly colored photosynthetic pigments stain the water. Water quality in the Gulf is an ongoing problem for Australia, as irrigation projects have diverted the already small flow of freshwater that empties into the Gulf. Other problems include contamination with pesticides and agricultural and residential fertilizer. On both the Eyre Peninsula and in the Victoria Territory to the east of Spencer Gulf, dark-colored rectangles show the boundaries of parks and nature preserves where the natural, drought-tolerant vegetation thrives.

  10. Gallbladder Volvulus: A Rare Emergent Cause of Acute Cholecystitis, if Untreated, Progresses to Necrosis and Perforation

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

    Justin L, Regner, E-mail: Justin.Regner@BSWHealth.org; Angela, Lomas

    An 86 year-old woman with a past medical history significant for abdominal hernia and Alzheimer dementia presented to the Emergency Department with a 24 hour history of acute right upper quadrant pain associated with nausea and non-bilious emesis. Physical exam revealed right sided abdominal tenderness with associated mass. All laboratory values were within normal ranges. Both abdominal ultrasound and computed tomography of the abdomen/pelvis revealed a large distended gallbladder with wall thickening and gallstones. Based on presentation and radiologic findings, the emergency general surgery service was consulted for suspected acute cholecystitis. The patient was then admitted for intravenous antibiotics andmore » scheduled for laparoscopic cholecystectomy the following day. Intra-operative findings revealed volvulus with acute necrosis of the entire gallbladder. The gallbladder had a long pedunculated cystic duct and artery that was detorsed before proceeding with resection. Postoperatively, the patient did well and was discharged a few days later tolerating a regular diet.« less

  11. Using Hybrid Magnetic Bearings to Completely Suspend the Impeller of a Ventricular Assist Device.

    PubMed

    Khanwilkar, Pratap; Olsen, Don; Bearnson, Gill; Allaire, Paul; Maslen, Eric; Flack, Ron; Long, James

    1996-05-01

    Clinically available blood pumps and those under development suffer from poor mechanical reliability and poor biocompatibility related to anatomic fit, hemolysis, and thrombosis. To alleviate these problems concurrently in a long-term device is a substantial challenge. Based on testing the performance of a prototype, and on our judgment of desired characteristics, we have configured an innovative ventricular assist device, the CF-VAD4, for long-term use. The design process and its outcome, the CFVAD4 system configuration, is described. To provide unprecedented reliability and biocompatibility, magnetic bearings completely suspend the rotating pump impeller. The CFVAD4 uses a combination of passive (permanent) and active (electric) magnetic bearings, a mixed flow impeller, and a slotless 3-phase brushless DC motor. These components are shaped, oriented, and integrated to provide a compact, implantable, pancake-shaped unit for placement in the left upper abdominal quadrant of adult humans. © 1996 International Society for Artificial Organs.

  12. Coseismic Compression/Dilatation and Viscoelastic Uplift/Subsidence Following the 2012 Indian Ocean Earthquakes Quantified from Satellite Gravity Observations

    NASA Technical Reports Server (NTRS)

    Han, Shin-Chan; Sauber, Jeanne; Pollitz, Fred

    2015-01-01

    The 2012 Indian Ocean earthquake sequence (M(sub w) 8.6, 8.2) is a rare example of great strike slip earthquakes in an intra-oceanic setting. With over a decade of GRACE data, we were able to measure and model the unanticipated large co-, and post-seismic gravity changes of these events. Using the approach of normal mode decomposition and spatial localization, we computed the gravity changes corresponding to five moment tensor components. Our analysis revealed that the gravity changes are produced predominantly by coseismic compression and dilatation within the oceanic crust and upper mantle and by post-seismic vertical motion. Our results suggest that the post-seismic positive gravity and the post-seismic uplift measured with GPS within the coseismic compressional quadrant are best fit by ongoing uplift associated with viscoelastic mantle relaxation. Our study demonstrates that the GRACE data are suitable for analyzing strike-slip earthquakes as small as M(sub w) 8.2 with the noise characteristics of this region.

  13. Transcatheter Embolization for Delayed Hemorrhage Caused by Blunt Splenic Trauma

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

    Krohmer, Steven J., E-mail: Steven.J.Krohmer@hitchcock.org; Hoffer, Eric K., E-mail: eric.k.hoffer@hitchcock.or; Burchard, Kenneth W., E-mail: Kenneth.W.Burchard@hitchcock.or

    2010-08-15

    Although the exact benefit of adjunctive splenic artery embolization (SAE) in the nonoperative management (NOM) of patients with blunt splenic trauma has been debated, the role of transcatheter embolization in delayed splenic hemorrhage is rarely addressed. The purpose of this study was to evaluate the effectiveness of SAE in the management of patients who presented at least 3 days after initial splenic trauma with delayed hemorrhage. During a 24-month period 4 patients (all male; ages 19-49 years) presented with acute onset of pain 5-70 days after blunt trauma to the left upper quadrant. Two had known splenic injuries that hadmore » been managed nonoperatively. All had computed axial tomography evidence of active splenic hemorrhage or false aneurysm on representation. All underwent successful SAE. Follow-up ranged from 28 to 370 days. These cases and a review of the literature indicate that SAE is safe and effective for NOM failure caused by delayed manifestations of splenic arterial injury.« less

  14. Maxillary molar distalization with first class appliance

    PubMed Central

    Ramesh, Namitha; Palukunnu, Biswas; Ravindran, Nidhi; Nair, Preeti P

    2014-01-01

    Non-extraction treatment has gained popularity for corrections of mild-to-moderate class II malocclusion over the past few decades. The distalization of maxillary molars is of significant value for treatment of cases with minimal arch discrepancy and mild class II molar relation associated with a normal mandibular arch and acceptable profile. This paper describes our experience with a 16-year-old female patient who reported with irregularly placed upper front teeth and unpleasant smile. The patient was diagnosed to have angles class II malocclusion with moderate maxillary anterior crowding, deep bite of 4 mm on a skeletal class II base with an orthognathic maxilla and retrognathic mandible and normal growth pattern. She presented an ideal profile and so molar distalization was planned with the first-class appliance. Molars were distalised by 8 mm on the right and left quadrants and class I molar relation achieved within 4 months. The space gained was utilised effectively to align the arch and establish a class I molar and canine relation. PMID:24577171

  15. Apollo 12 Mission image - Modular Equipment Stowage Assemble (MESA) and the Fuel Cask on the Lunar Module (LM)

    NASA Image and Video Library

    1969-11-19

    AS12-48-7034 (19 Nov. 1969) --- A close-up view of a portion of quadrant II of the descent stage of the Apollo 12 Lunar Module (LM), photographed during the Apollo 12 extravehicular activity (EVA). At lower left is the LM's Y footpad. The empty Radioisotope Thermoelectric Generator (RTG) fuel cask is at upper right. The fuel capsule has already been removed and placed in the RTG. The RTG furnishes power for the Apollo Lunar Surface Experiments Package (ALSEP) which the Apollo 12 astronauts deployed on the moon. The LM's descent engine skirt is in the center background. The rod-like object protruding out from under the footpad is a lunar surface sensing probe. Astronaut Richard F. Gordon Jr., command module pilot, remained with the Command and Service Modules (CSM) in lunar orbit while astronauts Charles Conrad Jr., commander; and Alan L. Bean, lunar module pilot, descended in the LM to explore the moon.

  16. On non-parametric maximum likelihood estimation of the bivariate survivor function.

    PubMed

    Prentice, R L

    The likelihood function for the bivariate survivor function F, under independent censorship, is maximized to obtain a non-parametric maximum likelihood estimator &Fcirc;. &Fcirc; may or may not be unique depending on the configuration of singly- and doubly-censored pairs. The likelihood function can be maximized by placing all mass on the grid formed by the uncensored failure times, or half lines beyond the failure time grid, or in the upper right quadrant beyond the grid. By accumulating the mass along lines (or regions) where the likelihood is flat, one obtains a partially maximized likelihood as a function of parameters that can be uniquely estimated. The score equations corresponding to these point mass parameters are derived, using a Lagrange multiplier technique to ensure unit total mass, and a modified Newton procedure is used to calculate the parameter estimates in some limited simulation studies. Some considerations for the further development of non-parametric bivariate survivor function estimators are briefly described.

  17. Synthesis and characterization of a small analogue of the anticancer natural product leinamycin.

    PubMed

    Keerthi, Kripa; Rajapakse, Anuruddha; Sun, Daekyu; Gates, Kent S

    2013-01-01

    Leinamycin (1) is a Streptomyces-derived natural product that displays nanomolar IC(50) values against human cancer cell lines. In the work described here, we report the synthesis and characterization of a small leinamycin analogue 19 that closely resembles the 'upper-right quadrant' of the natural product, consisting of an alicyclic 1,2-dithiolan-3-one 1-oxide heterocycle connected to an alkene by a two-carbon linker. The results indicate that this small analogue contains the core set of functional groups required to enable thiol-triggered generation of both redox active polysulfides and an episulfonium ion intermediate via the complex reaction cascade first seen in the natural product leinamycin. The small leinamycin analogue 19 caused thiol-triggered oxidative DNA strand cleavage in a manner similar to the natural product, but did not alkyate duplex DNA effectively. This highlights the central role of the 18-membered macrocycle of leinamycin in driving efficient DNA alkylation by the natural product. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. Superior versus inferior Ahmed glaucoma valve implantation.

    PubMed

    Pakravan, Mohammad; Yazdani, Shahin; Shahabi, Camelia; Yaseri, Mehdi

    2009-02-01

    To compare the efficacy and safety of Ahmed glaucoma valve (AGV) (New World Medical Inc., Rancho Cucamonga, CA) implantation in the superior versus inferior quadrants. Prospective parallel cohort study. A total of 106 eyes of 106 patients with refractory glaucoma. Consecutive patients with refractory glaucoma underwent AGV implantation in the superior or inferior quadrants. Main outcome measures included intraocular pressure (IOP) and rate of complications. Other outcome measures included best corrected visual acuity (BCVA), number of glaucoma medications, and success rate (defined as at least 30% IOP reduction and 50.122). After 1 year, statistically significant but comparable IOP reduction from baseline (P<0.001) was achieved in both groups (47.0%+/-27.2% and 43.0%+/-24.5% reduction for superior and inferior groups, respectively, P = 0.725). The mean number of glaucoma medications was comparable after 1 year (1.3+/-1.2 vs. 1.9+/-0.8 for superior and inferior implants, respectively, P = 0.256). Success rates were also similar at 1 year: 27 eyes (81.8%) versus 20 eyes (95.2%) for superior and inferior implants, respectively (P = 0.227). However, the overall rate of complications, such as implant exposure necessitating removal, cosmetically unappealing appearance, and endophthalmitis, was higher in the inferior group: 12 eyes (25%) versus 3 eyes (5.2%) for superior and inferior groups, respectively, (P = 0.004). Superior and inferior AGV implants have similar intermediate efficacy in terms of IOP reduction, decrease in number of glaucoma medications, and preservation of vision. However, the inferior quadrants entail significantly more complications. It may be prudent to avoid AGV implantation in the inferior quadrants if the superior quadrants have no contraindications to surgery. Proprietary or commercial disclosure may be found after the references.

  19. The Role of Thermodynamic Processes in the Evolution of Single and Multi-banding within Winter Storms

    NASA Astrophysics Data System (ADS)

    Ganetis, Sara Anne

    Mesoscale precipitation bands within Northeast U.S. (NEUS) winter storms result in heterogeneous spatial and temporal snowfall. Several studies have provided analysis of snowbands focusing on larger, meso-beta scale bands with lengths (L) > 200 km known as single bands. NEUS winter storms can also exhibit multiple bands with meso-beta scale (L < 200 km) and similar spatial orientation and when ≥ 3 occur are termed multi-bands; however, the genesis and evolution of multi-bands is less well understood. Unlike single bands, there is no multi-bands climatological study. In addition, there has been little detailed thermodynamic analysis of snowbands. This dissertation utilizes radar observations, reanalyses, and high-resolution model simulations to explore the thermodynamic evolution of single and multi-bands. Bands are identified within 20 cool season (October-April) NEUS storms. The 110-case dataset was classified using a combination of automated and manual methods into: single band only (SINGLE), multi-bands only (MULTI), both single and multi-bands (BOTH), and non-banded (NONE). Multi-bands occur with the presence of a single band in 55.4% of times used in this study, without the presence of a single band 18.1% of the time, and precipitation exhibits no banded characteristics 23.8% of the time. Most MULTI events occur in the northeast quadrant of a developing cyclone poleward of weak-midlevel forcing along a warm front, whereas multi-bands associated with BOTH events mostly occur in the northwest quadrant of mature cyclones associated with strong mid-level frontogenesis and conditional symmetric instability. The non-banded precipitation associated with NONE events occur in the eastern quadrants of developing and mature cyclones lacking mid-level forcing to concentrate the precipitation into bands. A high-resolution mesoscale model is used to explore the evolution of single and multi-bands based on two case studies, one of a single band and one of multi-bands. The multi-bands form in response to intermittent mid-level frontogenetical forcing in a conditionally unstable environment. The bands within their genesis location southeast of the single band move northwest towards the single band by 700-hPa steering flow. This allows for the formation of new multi-bands within the genesis region, unlike the single band that remains fixed to a 700-hPa frontogenesis maximum. Latent heating within the band is shown to increase the intensity and duration of single and multi-bands through decreased geopotential height below the heating maximum that leads to increased convergence within the band.

  20. Retinal neurodegeneration in patients with type 1 diabetes mellitus: the role of glycemic variability.

    PubMed

    Picconi, Fabiana; Parravano, Mariacristina; Ylli, Dorina; Pasqualetti, Patrizio; Coluzzi, Sara; Giordani, Ilaria; Malandrucco, Ilaria; Lauro, Davide; Scarinci, Fabio; Giorno, Paola; Varano, Monica; Frontoni, Simona

    2017-05-01

    Recent studies have identified neuroretinal abnormalities in persons affected by diabetes mellitus, before the onset of microvascular alterations. However, the role of glycemic variability (GV) on early retinal neurodegeneration is still not clarified. To explore the relationship between glycemic control and neuroretinal characteristics, 37 persons with Type 1 diabetes mellitus (Type 1 DM) divided into two groups with no signs (noRD) and with mild non-proliferative diabetic retinopathy (NPDR) compared to 13 healthy control participants (C) were recruited. All persons underwent an optical coherence tomography with automatic segmentation of all neuroretinal layers. Measurements of mean of nasal (N)/temporal (T)/superior (S)/inferior (I) macular quadrants for individual layer were also calculated. Metabolic control was evaluated by glycated hemoglobin (HbA1c), and indexes of GV were calculated from continuous glucose monitoring. The difference among the three groups in terms of RNFL thickness was significantly dependent on quadrant (F(6;132) = 2.315; p = 0.037). This interaction was due to a specific difference in RNFL-N thickness, where both Type 1 DM groups showed a similar reduction versus C (-3.9 for noDR and -4.9 for NPDR), without any relevant difference between them (-1.0). Inner nuclear layer (INL) was increased in all quadrants in the two Type 1 DM groups compared to C (mean difference = 7.73; 95% CI: 0.32-15.14, p = 0.043; mean difference = 7.74; 95% CI: 0.33-15.15, p = 0.043, respectively). A negative correlation between RNFL-N and low blood glucose index (r = -0.382, p = 0.034) and positive correlation between INL and continuous overall net glycemic action -1, -2, -4 h (r = 0.40, p = 0.025; r = 0.39, p = 0.031; r = 0.41, p = 0.021, respectively) were observed in Type 1 DM patients. The triglycerides were positively and significantly correlated to INL (r = 0.48, p = 0.011), in Type 1 DM subjects. GV and triglycerides resulted both independent predictors of increased INL thickness. No correlation was found with HbA1c. Early structural damage of neuroretina in persons with Type 1 DM patients is related to glucose fluctuations. GV should be addressed, even in the presence of a good metabolic control.

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