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Title: Aneurysm Physics can be Lethal

Authors:
 [1]
  1. Los Alamos National Laboratory
Publication Date:
Research Org.:
Los Alamos National Lab. (LANL), Los Alamos, NM (United States)
Sponsoring Org.:
USDOE
OSTI Identifier:
1291252
Report Number(s):
LA-UR-16-25328
DOE Contract Number:
AC52-06NA25396
Resource Type:
Conference
Resource Relation:
Conference: 2016 Student Symposium ; 2016-08-03 - 2016-08-03 ; Los Alamos, New Mexico, United States
Country of Publication:
United States
Language:
English
Subject:
Biological Science; Computer Science

Citation Formats

Lopez, Kimberly A. Aneurysm Physics can be Lethal. United States: N. p., 2016. Web.
Lopez, Kimberly A. Aneurysm Physics can be Lethal. United States.
Lopez, Kimberly A. 2016. "Aneurysm Physics can be Lethal". United States. doi:. https://www.osti.gov/servlets/purl/1291252.
@article{osti_1291252,
title = {Aneurysm Physics can be Lethal},
author = {Lopez, Kimberly A.},
abstractNote = {},
doi = {},
journal = {},
number = ,
volume = ,
place = {United States},
year = 2016,
month = 7
}

Conference:
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  • A theoretical framework to describe the formation of lethal mutations by radiation is presented. Lesions that are repaired (and misrepaired) in each type of experiment described (delayed plating and split dose) are assumed to be the same. In this model the same (potentially lethal) lesions cause both sublethal and potentially lethal damage. Potentially lethal damage is defined as damage which may be modified by alterations in postirradiation conditions. Sublethal damage is cellular damage whose accumulation may lead to lethality. A crucial consideration in the expression of the damage is the kind of medium in which the cells are placed duringmore » the repair period. Fresh or growth medium (F-medium) is assumed to cause fixation of damage after about 3 hours, while no fixation (only misrepair) occurs in conditioned medium (C-medium).« less
  • Magnetic resonance imaging (MRI) was performed in 20 patients with radiologically or surgically proven abdominal aortic aneurysms using a Siemens Magnetom scanner with a 0.35-T superconductive magnet. Of nine patients who underwent surgical repair, MRI correctly demonstrated the origin of the aortic aneurysm in nine and accurately determined the status of the iliac arteries in eight. Of 11 patients who did not have surgical repair, MRI findings correlated well with other radiologic studies. MRI was found to be more reliable than sonography in determining the relation between the aneurysm and the renal arteries as well as the status of themore » iliac arteries. Despite these advantages, the authors still advocate sonography as the screening procedure of choice in patients with suspected abdominal aortic aneurysms because of its lower cost and ease of performance. MRI should be reserved for patients who have had unsuccessful or equivocal sonographic examinations.« less
  • To compare the prognostic effect of aneurysmal infarct expansion (AN) to ejection fraction (EF), 52 consecutive high risk patients (pts) with initial anterior transmural myocardial infarction (MI) underwent 4-view bedside multigated cardiac blood pool imaging within 48 hours of chest pain and prehospital discharge. AN was strictly defined as an akinetic or diskinetic portion of the left ventricle which had diastolic deformity and was adjacent to areas with normal motion. EF < 35% was found to be the best EF cut-off for testing prediction of mortality. One year follow-up was performed by telephone interview (14 months, range 6-21). AN developedmore » in 18/52 pts (35%), 9 developed by 48 hours and 9 further predischarge. 35/52 patients (69%) had EF < 35%. One year mortality was 27% (14/52). AN was highly predictive of death: 11/18 pts with AN died, while only 3/34 without AN died (chi/sup 2/ = 16.35, rho <.001). This was independent of EF: EF did not differ between pts with and without AN (27.5 +- 8.8 vs 31.5 +- 11.2, rho NS). In contrast EF < 35% was not as useful in predicting mortality; 12/35 pts with EF < 35% died while 2/17 with EF greater than or equal to 35% (chi/sup 2/ = 2.95, rho NS). The presence of AN was equally sensitive (79% vs. 86%) and far more specific (82% vs. 39%) than EF for the prediction of mortality. The authors conclude, AN occurs frequently early following anterior MI and is an important and specific marker for mortality. It is superior to EF as a prognostic indicator in this high risk subset of pts and therefore may be a useful parameter in stratification of pts in trials designed to reduce mortality.« less
  • The Nuclear Stethoscope has been shown to reliably determine left ventricular (LV) ejection fraction (EF). However, the instrument differs from standard Anger camera techniques in that (1) it uses a single region-of-interest for assessing changes in radioactive counts, and (2) it is positioned ''blindly'' over the LV. For these reasons its accuracy in patients (pts) with LV aneurysm might be less than in pts with normal or less abnormal wall motion. The authors studied 30 consecutive pts by both standard dated blood pool (GBP) scanning and Nuclear Stethoscope (probe). Twenty pts had normal or mildly abnormal wall motion and 10more » had focal dyskinesis (aneurysm). The probe studies were performed by one of two experienced operators who were unaware of GBP results, and in 19 pts there were two separate probe acquisitions. Studies were performed in alternating sequence (i.e., GBP or probe first). GBP scans were acquired for 6 million counts spanning 24 frames, and probe studies for 60 or 120 sec (depending on the observed counting rate) in the ventricular function mode. Overall, the EF's ranged from 0.11 to 0.82, and the values from GBP and probe studies were highly correlated (r=O.93). In the 19 pts with two probe studies there was good interobserver reproducibility (r=0.96, SEE=0.05). The correlation between GBP and probe EF was similar in the 10 aneurysm pts (r=0.92, SEE=0.07) and the 20 pts with normal or mildly abnormal wall motion (r=0.92, SEE=0.08). The slope in the aneurysm pts (0.92) was not significantly different from that in the pts without aneurysm (0.97). These data confirm the accuracy of the Nuclear Stethoscope for determining EF and demonstrate its specific reliability in pts with LV aneurysm.« less