927 resultados para Portal vein thrombosis


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Cell loss and regeneration were investigated and compared in the retinal microvasculature of age- and sex-matched normal and streptozotocin diabetic rats. Selective pericyte loss in the diabetic rat was characterized by changes in the pericyte to endothelial cell ratio in retinal capillaries isolated for microscopy by the trypsin digest technique. A comparison of 3- and 9-month-old normal rats showed no significant change in the pericyte to endothelial cell ratio (1:2.7). In diabetic animals the ratio was reduced to 1:4.03, which was statistically significant (P less than .001). Premitotic retinal vascular cells in normal and diabetic rats were labelled with tritiated thymidine and the labelling indices calculated from cell counts of trypsin digest preparations. Methyl H3 thymidine was infused continuously over an eight-day period using osmotic mini pumps. The labelling index of endothelial cells (0.33%) in normal rats increased to 0.91% in diabetic animals (P less than .05). The labelling index of pericyte cells in normal animals (0.16%) did not increase significantly (P greater than .05) in diabetic animals (0.19%). A special stain was used to exclude labelled polymorphonuclear leukocytes from the cell counts.

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We induced choroidal neovascularization in the rhesus monkey by impoverishing the blood supply to the inner retina and producing defects in Bruch's membrane by photocoagulation. Fourteen of 46 eyes undergoing photocoagulation developed neovascular fronds which were identified and categorized by histopathologic examination and fluorescein angiography. All new vessels gained access to the retina through defects in Bruch's membrane at the site of photocoagulation marks. In eight eyes the new vessels remained localized to the immediate vicinity of photocoagulation marks. In four eyes neovascular fronds infiltrated the subretinal space for distances up to 6 disk diameters from the point of entry into the retina. In the two eyes choroidovitreal neovascular complexes developed but rapidly regressed shortly after gaining the vitreous cavity. Fluorescein angiography demonstrated that all neovascular fronds were grossly incompetent to dye but that formed feeding channels had some degree of integrity. Light microscopic studies showed the proliferating networks to be composed of capillaries with well-formed basement membranes and more mature vessels with the basic structure of choroidal arteries and veins.

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The design of hot-rolled steel portal frames can be sensitive to serviceability deflection limits. In such cases, in order to reduce frame deflections, practitioners increase the size of the eaves haunch and / or the sizes of the steel sections used for the column and rafter members of the frame. This paper investigates the effect of such deflection limits using a real-coded niching genetic algorithm (RC-NGA) that optimizes frame weight, taking into account both ultimate as well as serviceability limit states. The results show that the proposed GA is efficient and reliable. Two different sets of serviceability deflection limits are then considered: deflection limits recommended by the Steel Construction Institute (SCI), which is based on control of differential deflections, and other deflection limits based on suggestions by industry. Parametric studies are carried out on frames with spans ranging between 15 m to 50 m and column heights between 5 m to 10 m. It is demonstrated that for a 50 m span frame, use of the SCI recommended deflection limits can lead to frame weights that are around twice as heavy as compared to designs without these limits.

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A 25 year old man was brought into the emergency
department by ambulance. He was involved in a road
traffic incident and had an obvious site of blood loss from
a fracture of an upper limb. On his arrival at the
emergency department, you are told that the ambulance
paramedic was unable to gain intravenous access and
are asked by the person in charge of resuscitation to try
to gain access. You are unable to find any peripheral
veins because he is hypovolemic. You attempt to put in a
central line via the femoral vein (fig 1).

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Mineral exploration programmes around the world use data from remote sensing, geophysics and direct sampling. On a regional scale, the combination of airborne geophysics and ground-based geochemical sampling can aid geological mapping and economic minerals exploration. The fact that airborne geophysical and traditional soil-sampling data are generated at different spatial resolutions means that they are not immediately comparable due to their different sampling density. Several geostatistical techniques, including indicator cokriging and collocated cokriging, can be used to integrate different types of data into a geostatistical model. With increasing numbers of variables the inference of the cross-covariance model required for cokriging can be demanding in terms of effort and computational time. In this paper a Gaussian-based Bayesian updating approach is applied to integrate airborne radiometric data and ground-sampled geochemical soil data to maximise information generated from the soil survey, to enable more accurate geological interpretation for the exploration and development of natural resources. The Bayesian updating technique decomposes the collocated estimate into a production of two models: prior and likelihood models. The prior model is built from primary information and the likelihood model is built from secondary information. The prior model is then updated with the likelihood model to build the final model. The approach allows multiple secondary variables to be simultaneously integrated into the mapping of the primary variable. The Bayesian updating approach is demonstrated using a case study from Northern Ireland where the history of mineral prospecting for precious and base metals dates from the 18th century. Vein-hosted, strata-bound and volcanogenic occurrences of mineralisation are found. The geostatistical technique was used to improve the resolution of soil geochemistry, collected one sample per 2 km2, by integrating more closely measured airborne geophysical data from the GSNI Tellus Survey, measured over a footprint of 65 x 200 m. The directly measured geochemistry data were considered as primary data in the Bayesian approach and the airborne radiometric data were used as secondary data. The approach produced more detailed updated maps and in particular maximized information on mapped estimates of zinc, copper and lead. Greater delineation of an elongated northwest/southeast trending zone in the updated maps strengthened the potential to investigate stratabound base metal deposits.

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Objective: To simultaneously evaluate 14 biomarkers from distinct biological pathways for risk prediction of ischemic stroke, including biomarkers of hemostasis, inflammation, and endothelial activation as well as chemokines and adipocytokines.
Methods and Results: The Prospective Epidemiological Study on Myocardial Infarction (PRIME) is a cohort of 9771 healthy men 50 to 59 years of age who were followed up over 10 years. In a nested case–control study, 95 ischemic stroke cases were matched with 190 controls. After multivariable adjustment for traditional risk factors, fibrinogen (odds ratio [OR], 1.53; 95% confidence interval [CI], 1.03–2.28), E-selectin (OR, 1.76; 95% CI, 1.06–2.93), interferon-γ-inducible-protein-10 (OR, 1.72; 95% CI, 1.06–2.78), resistin (OR, 2.86; 95% CI, 1.30–6.27), and total adiponectin (OR, 1.82; 95% CI, 1.04–3.19) were significantly associated with ischemic stroke. Adding E-selectin and resistin to a traditional risk factor model significantly increased the area under the receiver-operating characteristic curve from 0.679 (95% CI, 0.612–0.745) to 0.785 and 0.788, respectively, and yielded a categorical net reclassification improvement of 29.9% (P=0.001) and 28.4% (P=0.002), respectively. Their simultaneous inclusion in the traditional risk factor model increased the area under the receiver-operating characteristic curve to 0.824 (95% CI, 0.770–0.877) and resulted in an net reclassification improvement of 41.4% (P<0.001). Results were confirmed when using continuous net reclassification improvement.
Conclusion: Among multiple biomarkers from distinct biological pathways, E-selectin and resistin provided incremental and additive value to traditional risk factors in predicting ischemic stroke.

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OBJECTIVE: The present work was planned to report the incidence of calcification and ossification of an isolated cranial dural fold. The form, degree of severity and range of extension of such changes will be described. Involvement of the neighboring brain tissue and blood vessels, whether meningeal or cerebral, will also be determined. The results of this study might highlight the occasional incidence of intracranial calcification and ossification in images of the head and their interpretation, by radiologists and neurologists, to be of dural or vascular origin.

METHODS: Two human formalin-fixed cadavers, one middle-aged female another older male, were investigated at the Anatomy Laboratory, College of Medicine, King Faisal University, Dammam, Kingdom of Saudi Arabia during the period from 2000 to 2003. In each cadaver, the skullcap was removed and the convexity of the cranial dura mater, as well as the individual dural folds, were carefully examined for any calcification or ossification. The meningeal and cerebral blood vessels together with the underlying brain were grossly inspected for such structural changes. Calcified or ossified tissues, when identified, were subjected to histological examination to confirm their construction.

RESULTS: The female cadaver showed a calcified parietal emissary vein piercing the skullcap and projecting into the scalp. The latter looked paler and deficient in hair on its right side. The base of the stump was surrounded by a granular patch of calcification. The upper convex border of the falx cerebri was hardened and it presented granules, plaques and a cauliflower mass, which all proved to be osseous in structure. The meningeal and right cerebral vessels were mottled with calcium granules. The underlying temporal and parietal lobes of the right cerebral hemisphere were degenerated. The male cadaver also revealed a calcified upper border of the falx cerebri and superior sagittal sinus. Osseous granules and plaques, similar to those of the first specimen, were also identified but without gross changes in the underlying brain.

CONCLUSION: Calcification or ossification of an isolated site of the cranial dura mater and the intracranial blood vessels might occur. These changes should be kept in mind while interpreting images of the skull and brain. Clinical assessment and laboratory investigations are required to determine whether these changes are idiopathic, traumatic, or as a manifestation of a generalized disease such as hyperparathyroidism, vitamin D-intoxication, or chronic renal failure.

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A full-scale, non-uniform natural fire test on a cold-formed steel portal frame building is described. The results of the test are used to validate a non-linear, elasto-plastic, finite element shell idealisation, for the purposes of later forming the basis of a performance-based design approach for cold-formed steel portal frames at elevated temperatures.

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This paper describes the results of non-linear elasto-plastic implicit dynamic finite element analyses that are used to predict the collapse behaviour of cold-formed steel portal frames at elevated temperatures. The collapse behaviour of a simple rigid-jointed beam idealisation and a more accurate semi-rigid jointed shell element idealisation are compared for two different fire scenarios. For the case of the shell element idealisation, the semi-rigidity of the cold-formed steel joints is explicitly taken into account through modelling of the bolt-hole elongation stiffness. In addition, the shell element idealisation is able to capture buckling of the cold-formed steel sections in the vicinity of the joints. The shell element idealisation is validated at ambient temperature against the results of full-scale tests reported in the literature. The behaviour at elevated temperatures is then considered for both the semi-rigid jointed shell and rigid-jointed beam idealisations. The inclusion of accurate joint rigidity and geometric non-linearity (second order analysis) are shown to affect the collapse behaviour at elevated temperatures. For each fire scenario considered, the importance of base fixity in preventing an undesirable outwards collapse mechanism is demonstrated. The results demonstrate that joint rigidity and varying fire scenarios should be considered in order to allow for conservative design.

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OBJECTIVE: The antitumor effects of FK506-binding protein like (FKBPL) and its extracellular role in angiogenesis are well characterized; however, its role in physiological/developmental angiogenesis and the effect of FKBPL ablation has not been evaluated. This is important as effects of some angiogenic proteins are dosage dependent. Here we evaluate the regulation of FKBPL secretion under angiogenic stimuli, as well as the effect of FKBPL ablation in angiogenesis using mouse and zebrafish models.

APPROACH AND RESULTS: FKBPL is secreted maximally by human microvascular endothelial cells and fibroblasts, and this was specifically downregulated by proangiogenic hypoxic signals, but not by the angiogenic cytokines, VEGF or IL8. FKBPL's critical role in angiogenesis was supported by our inability to generate an Fkbpl knockout mouse, with embryonic lethality occurring before E8.5. However, whilst Fkbpl heterozygotic embryos showed some vasculature irregularities, the mice developed normally. In murine angiogenesis models, including the ex vivo aortic ring assay, in vivo sponge assay, and tumor growth assay, Fkbpl(+/-) mice exhibited increased sprouting, enhanced vessel recruitment, and faster tumor growth, respectively, supporting the antiangiogenic function of FKBPL. In zebrafish, knockdown of zFkbpl using morpholinos disrupted the vasculature, and the phenotype was rescued with hFKBPL. Interestingly, this vessel disruption was ineffective when zcd44 was knocked-down, supporting the dependency of zFkbpl on zCd44 in zebrafish.

CONCLUSIONS: FKBPL is an important regulator of angiogenesis, having an essential role in murine and zebrafish blood vessel development. Mouse models of angiogenesis demonstrated a proangiogenic phenotype in Fkbpl heterozygotes.

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This paper describes a stressed-skin diaphragm approach to the optimal design of the internal frame of a cold-formed steel portal framing system, in conjunction with the effect of semi-rigid joints. Both ultimate and serviceability limit states are considered. Wind load combinations are included. The designs are optimized using a real-coded niching genetic algorithm, in which both discrete and continuous decision variables are processed. For a building with two internal frames, it is shown that the material cost of the internal frame can be reduced by as much as 53%, compared with a design that ignores stressed-skin action.

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This paper considers the optimal design of fabricated steel beams for long-span portal frames. The design optimisation takes into account ultimate as well as serviceability limit states, adopting deflection limits recommended by the Steel Construction Institute (SCI). Results for three benchmark frames demonstrate the efficiency of the optimisation methodology. A genetic algorithm (GA) was used to optimise the dimensions of the plates used for the columns, rafters and haunches. Discrete decision variables were adopted for the thickness of the steel plates and continuous variables for the breadth and depth of the plates. Strategies were developed to enhance the performance of the GA including solution space reduction and a hybrid initial population half of which is derived using Latin hypercube sampling. The results show that the proposed GA-based optimisation model generates optimal and near-optimal solutions consistently. A parametric study is then conducted on frames of different spans. A significant variation in weight between fabricated and conventional hot-rolled steel portal frames is shown; for a 50 m span frame, a 14–19% saving in weight was achieved. Furthermore, since Universal Beam sections in the UK come from a discrete section library, the results could also provide overall dimensions of other beams that could be more efficient for portal frames. Eurocode 3 was used for illustrative purposes; any alternative code of practice may be used.

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The design optimization of a cold-formed steel portal frame building is considered in this paper. The proposed genetic algorithm (GA) optimizer considers both topology (i.e., frame spacing and pitch) and cross-sectional sizes of the main structural members as the decision variables. Previous GAs in the literature were characterized by poor convergence, including slow progress, that usually results in excessive computation times and/or frequent failure to achieve an optimal or near-optimal solution. This is the main issue addressed in this paper. In an effort to improve the performance of the conventional GA, a niching strategy is presented that is shown to be an effective means of enhancing the dissimilarity of the solutions in each generation of the GA. Thus, population diversity is maintained and premature convergence is reduced significantly. Through benchmark examples, it is shown that the efficient GA proposed generates optimal solutions more consistently. A parametric study was carried out, and the results included. They show significant variation in the optimal topology in terms of pitch and frame spacing for a range of typical column heights. They also show that the optimized design achieved large savings based on the cost of the main structural elements; the inclusion of knee braces at the eaves yield further savings in cost, that are significant.