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Coronary-pulmonary artery fistula is a rare anomaly in which an aortopulmonary collateral artery arises from a coronary artery, often seen in patients with pulmonary atresia with ventricular septal defect. In the presented case, a coronary-pulmonary artery fistula arose from the left main coronary artery and supplied blood flow to a left upper lobe segment. The life-sized three-dimensional printed model was helpful in pre-surgical planning for unifocalisation of the aortopulmonary collateral arteries.
Acute pulmonary embolism is a life-threatening condition and rarely occurs in children. In adults, catheter-directed therapy emerges as a potentially safer and effective therapeutic option. However, there is a paucity of data on the safety and efficacy of catheter-directed therapy for pulmonary embolism in children. We report a single-centred experience of catheter-directed therapy for acute pulmonary embolism in children.
This is a retrospective study of children who had no CHD and underwent catheter-directed therapy at Detroit Medical Center during a 12-year period from 2005 to 2017. Demographic and clinical data associated with pulmonary embolism were collected along with the outcome.
A total of nine patients of median age 16 years with the range from 12 to 20 received catheter-directed therapy for sub-massive (n = 6) and massive pulmonary embolism (n = 3). Among nine patients, one patient received Angiojet thrombectomy and balloon angioplasty, whereas eight patients received catheter-directed thrombolysis using tissue plasminogen activator through infusion catheters (n = 3) or EkoSonic ultrasound-accelerated thrombolysis system (n = 5). In four out of five patients treated with EkoSonic, significant clinical improvement was noticed within 24 hours. Among seven patients who survived, two patients had minor gastrointestinal bleeding with median hospital stay of 8 days with the range from 5 to 24 days, and two patients with massive pulmonary embolism died possibly due to delayed institution of catheter-directed therapy.
Catheter-directed therapy with/without EkoSonic is an emerging alternative therapy for sub-massive and massive pulmonary embolism in children. A timely institution of catheter-directed therapy appeared important to improve the outcome.
Anomalous drainage of the right superior caval vein into the left atrium is a rare congenital anomaly that causes cyanosis and occult infection owing to right-to-left shunting. Transcatheter management of this anomaly is unique and rarely reported. We report a 32-year-old man with a history of brain abscess, who was diagnosed with an anomalous right superior caval vein draining to the left atrium; right upper pulmonary vein and right middle pulmonary vein draining into the inferior portion of the right superior caval vein; and a left superior caval vein draining into the right atrium through the coronary sinus without a bridging vein. Pre-procedural planning was guided by three-dimensional printed model. The right superior caval vein was occluded with a 16-mm Amplatzer muscular Ventricular Septal Defect occluder inferior to the azygous vein, but superior to the entries of right upper and middle pulmonary veins. This diverted the right superior caval vein flow to the inferior caval vein system through the azygos vein in a retrograde manner and allowed the right upper pulmonary vein and right middle pulmonary vein flow to drain into the left atrium normally, achieving exclusion of right-to-left shunting and allowing normal drainage of pulmonary veins into the left atrium. At the 6-month follow-up, his saturation improved from 93 to 97% with no symptoms of superior caval vein syndrome.
Parents may experience anxiety and stress when their children undergo cardiac catheterisation. The goal of this study was to assess the level of anxiety in parents of children undergoing cardiac catheterisation and to identify factors that were associated with level of anxiety.
This was a cross-sectional survey of parents of children who underwent cardiac catheterisation. Anxiety levels were measured using a validated self-report questionnaire – State-Trait Anxiety Inventory, which generates state anxiety scores on the current state of anxiety and trait anxiety scores on the stable aspects of anxiety proneness. One sample t-test was used to compare the data with normative data. Multiple linear regression was used to assess the factors associated with the state score.
A total of 113 parents completed the survey. The mean age of parents was 34.0±7.7 years and the mean age of children undergoing catheterisation was 6.7±5.7 years. Compared with normative data, mean state score was significantly higher in our cohort (p<0.05) despite no difference in the trait score. Final multivariate model showed that the state score was significantly associated with child age group (<1 year [coefficient β 7.2] and 10–18 years [6.3], compared to 1 to <10 years of age [reference]) and history of previous catheterisation (−5.2) (p<0.05).
Concurrent state anxiety level was high among parents of children undergoing cardiac catheterisation, whereas trait anxiety level was not. Higher anxiety was experienced by parents of infants and adolescents without a history of previous catheterisation.
We have conducted astrometric observations toward a 22 GHz water maser source associated with the Sgr B2 complex in the Galactic center region with VERA (VLBI exploration of Radio Astrometry). We measured a trigonometric parallax and absolute proper motion of the Sgr B2 complex with respect to an extra-galactic source by observing the water maser source at 10 epochs from 2014 to 2017. The measured distance was 7.52+3.01−1.67 kpc for the Sgr B2M region.
We also succeeded to measure internal motions of maser spots in Sgr B2M, and N region. The number of spots which we could measure the internal motions is about 400. The distribution of the maser spots shows that the maser spots are associated with envelope of HII region seen in radio continuum image obtained with VLA and ALMA. We discuss relative motions between Sgr B2M, and N by using the internal motion.
In this proceeding paper, we introduce the recent results of Galactic maser astrometry by mainly focusing on those obtained with Japanese VLBI array VERA. So far we have obtained parallaxes for 86 sources including preliminary results, and combination with the data obtained with VLBA/BeSSeL provides astrometric results for 159 sources. With these most updated results we conduct preliminary determinations of Galactic fundamental parameters, obtaining R0 = 8.16 ± 0.26 kpc and Θ0 = 237 ± 8 km/s. We also derive the rotation curve of the Milky Way Galaxy and confirm the previous results that the rotation curve is fairly flat between 5 kpc and 16 kpc, while a remarkable deviation is seen toward the Galactic center region. In addition to the results on the Galactic structure, we also present brief overviews on other science topics related to masers conducted with VERA, and also discuss the future prospect of the project.
We have detected [C I] 3P1–3P0 emissions in the gaseous debris disks of 49 Ceti and β Pictoris with the 10 m telescope of the Atacama Submillimeter Telescope Experiment, which is the first detection of such emissions. The line profiles of [C I] are found to resemble those of CO(J=3–2) observed with the same telescope and the Atacama Large Millimeter/submillimeter Array. This result suggests that atomic carbon (C) coexists with CO in the debris disks, and is likely formed by the photodissociation of CO. Assuming an optically thin [C I] emission with the excitation temperature ranging from 30 to 100 K, the column density of C is evaluated to be (2.2 ± 0.2) × 1017 and (2.5 ± 0.7) × 1016 cm−2 for 49 Ceti and β Pictoris, respectively. The C/CO column density ratio is thus derived to be 54 ± 19 and 69 ± 42 for 49 Ceti and β Pictoris, respectively. These ratios are higher than those of molecular clouds and diffuse clouds by an order of magnitude. The unusually high ratios of C to CO are likely attributed to a lack of H2 molecules needed to reproduce CO molecules efficiently from C. This result implies a small number of H2 molecules in the gas disk; i.e., there is an appreciable contribution of secondary gas from dust grains.
We report a critically ill premature infant with severe mitral valve regurgitation associated with pulmonary hypertension and a severely dilated left atrium from a large patent ductus arteriosus. The mitral valve regurgitation improved significantly with normalisation of left atrial size 4 weeks after percutaneous closure of the patent ductus arteriosus. This case highlights the potential reversibility of severe mitral valve regurgitation with treatment of an underlying cardiac shunt.
The Galactic centre region shows outstanding non-circular motion unlike the Galactic disk. As scenarios describing this non-circular motion, resonance orbits formed by the Galactic bar potential or expanding motion by past activity of the central BH are proposed. However, these both scenarios are based on line-of-sight velocities of molecular clouds in this region, and such one-dimension velocity information is insufficient to separate these scenarios.
To reveal dynamics of the Galactic centre region, we conducted astromertic observations of 22 GHz water maser sources toward the Galactic centre direction. We conducted astrometric observations toward water maser source associated with Sgr D HII region. As a result, we succeeded to measure the parallax and proper motion of the maser source. The measured distance was 2.36(+0.58/-0.39) kpc. This result clearly indicates that this source is not associated with the Galactic centre, but located on the Galactic disk.
The effect of Hybrid stage 1 palliation for hypoplastic left heart syndrome on right ventricular function is unknown. We sought to compare right ventricular function in normal neonates and those with hypoplastic left heart syndrome before Hybrid palliation and to assess the effect of Hybrid palliation on right ventricular function, using the right ventricular myocardial performance index and the ratio of systolic and diastolic durations.
We carried out a retrospective review of echocardiographic data on 23 infants with hypoplastic left heart syndrome who underwent Hybrid palliation and 35 normal controls. Data were acquired before Hybrid and after Hybrid palliation – post 1, 0–4 days; post 2, 1 week; post 3, 2–3 weeks; post 4, 1–1.5 months following Hybrid palliation.
Myocardial performance index and ratio of systolic and diastolic durations were higher in the pre-Hybrid hypoplastic left heart syndrome group (n=23) – 0.47±0.16 versus 0.25±0.07, p<0.001; 1.59±0.44 versus 1.09±0.14, p<0.0001 – compared with controls (n=35). There was no significant change in the myocardial performance index at any of the post-Hybrid time points. Ratio of systolic and diastolic durations increased significantly 2 weeks after Hybrid – post 3: 2.08±0.62 and post 4: 2.21±0.45 versus pre: 1.59±0.44, p=0.043 and 0.003. There were no significant differences in parameters between sub-groups of infants who died (n=10) and survivors (n=13).
Right ventricular myocardial performance index and ratio of systolic and diastolic durations were significantly higher in infants with hypoplastic left heart syndrome before intervention compared with controls. The ratio of systolic and diastolic durations increased significantly 2 weeks after Hybrid palliation. Our data suggest that infants with hypoplastic left heart syndrome have right ventricular dysfunction before intervention, which worsens over 2 weeks after Hybrid palliation.
The aim of the present study was to determine the effects of increased dietary intake and high fat diet (HFD) in mice on artificial oocyte activation by using puromycin or roscovitine. Six-week-old mice were fed as either a control diet group, an increased dietary intake group or an HFD group for 4 weeks. Oocytes were obtained following superovulation and were divided into three treatment groups (no activation treatment, calcium ionophore and puromycin treatment, and calcium ionophore and roscovitine treatment) and were incubated for 4 h. Retrieved oocytes and numbers of oocytes activated as assessed by morphological changes were compared among the three treatment groups. The proportion of degenerated oocytes in HFD mice was significantly higher than that in control diet mice. The rates of activation in oocytes treated with roscovitine were 90.3% in control diet mice, 89.8% in increased dietary intake mice and 67.9% in HFD mice. The rate of activation in oocytes treated with roscovitine in HFD mice was significantly lower than the rates in control diet mice and increased dietary intake mice. The rates of activation in oocytes treated with puromycin were 90.6% in control diet mice, 94.0% in increased dietary intake mice and 71.4% in HFD mice, and the rate of activation in oocytes treated with puromycin in HFD mice was significantly lower than the rates in control diet mice and increased dietary intake mice. HFD-induced obesity deteriorated induction of oocyte activation by roscovitine or puromycin in mice.
A survey was conducted to describe the characteristics of patients treated for hypothermia after the Great East Japan Earthquake.
Written questionnaires were distributed to 72 emergency medical hospitals in Miyagi Prefecture. Data were requested regarding inpatients with a temperature less than 36ºC admitted within 72 hours after the earthquake. The availability of functional heating systems and the time required to restore heating after the earthquake were also documented.
A total of 91 inpatients from 13 hospitals were identified. Tsunami victims comprised 73% of the patients with hypothermia. Within 24 hours of the earthquake, 66 patients were admitted. Most patients with a temperature of 32ºC or higher were treated with passive external rewarming with blankets. Discharge without sequelae was reported for 83.3% of patients admitted within 24 hours of the earthquake and 44.0% of those admitted from 24 to 72 hours after the earthquake. Heating systems were restored within 3 days of the earthquake at 43% of the hospitals.
Hypothermia in patients hospitalized within 72 hours of the earthquake was primarily due to cold-water exposure during the tsunami. Many patients were successfully treated in spite of the post-earthquake disruption of regional social infrastructure.(Disaster Med Public Health Preparedness. 2014;0:1-11)
We succeeded in growing carbon nanotubes in a photoelectron spectroscopy analysis system using thermal chemical vapor deposition and analyzed the chemical states of the Co catalysts by in-situ x-ray photoelectron spectroscopy before and after the growth. We found that almost all of the Co particles are metallic after the growth in both cases; Co particles are formed from a Co oxide thin film and a metallic Co thin film. This shows that the metallic state is stable for Co under low-pressure ethanol ambient in our growth condition for carbon nanotubes.
Degradation property of aluminum due to hydrogen is studied. Hydrogen is introduced by electrolysis charge in aqueous solution with addition of 0.1 mass % NH4SCN as a hydrogen recombination poison. The amount of hydrogen and its existing state in the material is analyzed by hydrogen desorption curves measured by the thermal desorption spectroscopy. The hydrogen desorption curves of charged aluminum showed two peaks, one at less than 100 °C and the other around 400 °C. The existing state of hydrogen relate to each peaks are identified as weakly trapped solute hydrogen to vacancy and free hydrogen molecule located in cavities that exists in the bulk of the material. Tensile properties are obtained to determine degradation property of the material due to hydrogen. The effect of hydrogen on degradation of charged aluminum is analyzed in terms of interaction between hydrogen and vacancy or dislocation. Solute hydrogen and cavities are found to affect ductility of aluminum, whereas hydrogen molecule in cavities has no effect.
We have developed a new method of eliminating defect states in Si. This method called cyanide treatment simply includes immersion of Si in KCN solutions followed by the rinse. The contamination by potassium ions can be completely prevented by the inclusion of 18-crown-6 in the KCN solutions (crown-ether cyanide treatment). When the crown-ether cyanide treatment was performed on intrinsic amorphous Si (a-Si) films, decreases in the photo-and dark current densities with the irradiation time were completely prevented. When cyanide treatment using aqueous KCN solutions was applied to pin-junction a-Si solar cells, the conversion efficiencies measured before and after light-induced degradation became higher than those with no treatment. These improvements are attributed to the elimination of defect and defect precursor states by the reaction with cyanide ions, resulting in the formation of Si-CN bonds. From density functional calculations, Si-CN bonds are found to possess a high bond energy of 4.5 eV. Due to the high bond energy, the bonds are not ruptured by heat treatment at 800°C and upon irradiation, resulting in the thermal and irradiation stability of the cyanide treatment.
We describe a 6-year-old boy with newly diagnosed Costello syndrome after the diagnosis of severe hypertrophic cardiomyopathy. His neonatal asymmetric septal cardiomyopathy resolved by 9 months of age but reappeared at 6 years of age. This report highlights two important concepts: the association of genetic syndromes with hypertrophic cardiomyopathy and the possibility of worsening severity of hypertrophic cardiomyopathy linked to growth hormone therapy.
The present paper describes the first reported case, to our knowledge, of a myoepithelioma arising in an accessory parotid gland. Because pre-operative fine-needle aspiration cytological findings and operative findings suggested that this tumour was malignant, the decision was made to remove the tumour surgically along with the buccal branches of the facial nerve. The resected nerve was reconstructed by nerve transplantation, using the great auricular nerve. Subsequently the tumour was found to be benign. One year after surgery, the patient had excellent facial nerve function and so far there has been no evidence of recurrence.