Extracorporeal membrane oxygenation as a bridge to diagnosis in a 20-month old girl with pulmonary hypertension and right ventricular failure

A 20-month old girl with severe pulmonary hypertension and cardiomegaly was admitted to the paediatric intensive care unit with right ventricular failure of unknown origin. Only after decompression of the heart chambers under extracorporeal membrane oxygenation (ECMO), did the pathognomonic membrane of Cor triatriatum become visible on echocardiography. The patient underwent successful surgical correction and subsequently cardiac function recovered completely. Cor triatriatum remains a rare congenital cardiac disorder with a variable presentation, often including recurrent respiratory infections before right-sided heart failure occurs. This case illustrates that ECMO can serve not only as a bridge to diagnosis, but can also facilitate correct diagnosis. Given the excellent outcome after surgical treatment, it is crucial that cardiologists rule out the possibility of cor triatriatum when assessing a child with unexplained pulmonary hypertension.

Mechanical circulatory support as a bridge to heart transplantation: what remains? Long-term emotional sequelae in patients and spouses

Implantation of a ventricular assist device (VAD) reduces short-term mortality and morbidity and provides patients with reasonable quality of life even though it may also be a long-lasting emotional burden. This study was conducted to analyze the long-time emotional consequences of VAD implantation, followed by heart transplantation in patients and spouses.

Effect of implementing project-based education in high school physics : file folder bridge engineering

Project-based education and portfolio assessments are at the forefront of educational research. This research follows the implementation of a project-based unit in a high school physics class. Students played the role of an engineering firm who designed, built and tested file folder bridges. The purpose was to determine if projectbased learning could improve student attitude toward science and related careers like engineering. Teams of students presented their work in a portfolio for a final assessment of the process of designing, building and testing their bridges.

Determining bridge deck deterioration through the use of 3D photogrammetry

The bridge inspection industry has yet to utilize a rapidly growing technology that shows promise to help improve the inspection process. This thesis investigates the abilities that 3D photogrammetry is capable of providing to the bridge inspector for a number of deterioration mechanisms. The technology can provide information about the surface condition of some bridge components, primarily focusing on the surface defects of a concrete bridge which include cracking, spalling and scaling. Testing was completed using a Canon EOS 7D camera which then processed photos using AgiSoft PhotoScan to align the photos and develop models. Further processing of the models was done using ArcMap in the ArcGIS 10 program to view the digital elevation models of the concrete surface. Several experiments were completed to determine the ability of the technique for the detection of the different defects. The cracks that were able to be resolved in this study were a 1/8 inch crack at a distance of two feet above the surface. 3D photogrammetry was able to be detect a depression of 1 inch wide with 3/16 inch depth which would be sufficient to measure any scaling or spalling that would be required be the inspector. The percentage scaled or spalled was also able to be calculated from the digital elevation models in ArcMap. Different camera factors including the distance from the defects, number of photos and angle, were also investigated to see how each factor affected the capabilities. 3D photogrammetry showed great promise in the detection of scaling or spalling of the concrete bridge surface.

Extracorporeal membrane oxygenation as a bridge to lung transplantation

The occurrence of severe graft failure after lung transplantation which appears refractory to conventional treatment represents a difficult situation with regard to the therapeutic strategies available. Of 17 patients undergoing single lung transplantation at our center, 2 developed early graft failure. In both, temporary artificial cardiopulmonary support by means of extracorporeal membrane oxygenation became necessary as a bridge to retransplantation. Both patients were successfully retransplanted after 8 h and 232 h, respectively, of extra-corporeal support. Postoperatively, there was a variety of complications. The first patient completely recovered from temporary severe cerebral dysfunction diagnosed as "locked-in syndrome". She was discharged from hospital on the 93rd postoperative day and remains alive and well 10 months after her operation. The other patient recovered well early after retransplantation. Later, however, airway problems developed, requiring the implantation of endotracheal stents. Cachexia and several episodes of viral pneumonia contributed to the progressive deterioration of her clinical status. She finally died after being hospitalized for 5 months after the original operation. These two cases illustrate the feasibility of using extracorporeal membrane oxygenation as a bridge to pulmonary transplantation.

The York Medal, or the supposed Jewish medal, found in New York, on the removal of Layer Thorpe old bridge und postern, in the year 1829

deciphered by L. Loewe