Venous bullet embolism and subsequent endovascular retrieval – A case report and review of the literature

AbstractINTRODUCTIONVascular bullet embolism is a rare phenomenon with fewer than 200 cases reported in the literature.PRESENTATION OF CASEA 22 year-old male presented with a gunshot wound to the right lower quadrant. Imaging demonstrated a bullet lodged in his left lower quadrant. Upon operative exploration, a single hole was found in the right external iliac vein without injury into the left lower quadrant. The bullet was found to have migrated intravascularly from the right external to the left common iliac vein, and was subsequently removed endovascularly.DISCUSSIONBullet embolism occurs infrequently, with arterial more common than venous. Arterial embolization usually requires emergency operative intervention due to ischemia. While venous embolization is often asymptomatic, removal of the bullet is recommended to avoid delayed complications when possible.CONCLUSIONVenous bullet emboli should be removed endovascularly whenever technically possible

BEST Endovascular Versus Best Surgical Therapy in Patients with Critical Limb Ischemia (BEST-CLI) Trial

The Best Endovascular versus Best Surgical Therapy in Patients with Critical Limb Ischemia trial (BEST-CLI) is an international, prospective, multicentre, multidisciplinary and pragmatic, open-label, superiority-based, comparative-effectiveness randomised controlled trial designed to address the knowledge gap in choosing the appropriate therapy for the treatment of critical limb ischaemia (CLI). This study compares the effectiveness of the best available surgical treatment with the best available endovascular treatment in adults with CLI who are eligible for both treatment options. The study has completed its enrolment phase and patients included in the study are currently being followed up to 50 months. Results of the study promise to provide us with answers to several questions regarding treatment options for patients with CLI, more recently referred to as chronic limb-threatening ischaemia

Mapping The Interstellar Medium With Near-Infrared Diffuse Interstellar Bands

We map the distribution and properties of the Milky Way's interstellar medium as traced by diffuse interstellar bands (DIBs) detected in near-infrared stellar spectra from the SDSS-III/APOGEE survey. Focusing exclusively on the strongest DIB in the H band, at lambda similar to 1.527 mu m, we present a projected map of the DIB absorption field in the Galactic plane, using a set of about 60,000 sightlines that reach up to 15 kpc from the Sun and probe up to 30 mag of visual extinction. The strength of this DIB is linearly correlated with dust reddening over three orders of magnitude in both DIB equivalent width (Wpm) and extinction, with a power law index of 1.01 +/- 0.01, a mean relationship of W-DIB/A(v) = 0.1 angstrom mag(-1) and a dispersion of similar to 0.05 angstrom mag(-1) at extinctions characteristic of the Galactic midplane. These properties establish this DIB as a powerful, independent probe of dust extinction over a wide range of Av values. The subset of about 14,000 robustly detected DIB features have a W-DIB distribution that follows an exponential trend. We empirically determine the intrinsic rest wavelength of this transition to be lambda(0) = 15 272.42 angstrom and use it to calculate absolute radial velocities of the carrier, which display the kinematical signature of the rotating Galactic disk. We probe the DIB carrier distribution in three dimensions and show that it can be characterized by an exponential disk model with a scale height of about 100 pc and a scale length of about 5 kpc. Finally, we show that the DIB distribution also traces large-scale Galactic structures, including the Galactic long bar and the warp of the outer disk.NSF Astronomy & Astrophysics Postdoctoral Fellowship AST-1203017NSF AST-1109665Alfred P. Sloan FoundationNational Science FoundationU.S. Department of Energy Office of ScienceUniversity of ArizonaBrazilian Participation GroupBrookhaven National LaboratoryUniversity of CambridgeCarnegie Mellon UniversityUniversity of FloridaFrench Participation GroupGerman Participation GroupHarvard UniversityInstituto de Astrofisica de CanariasMichigan State/Notre Dame/JINA Participation GroupJohns Hopkins UniversityLawrence Berkeley National LaboratoryMax Planck Institute for AstrophysicsMax Planck Institute for Extraterrestrial PhysicsNew Mexico State UniversityNew York UniversityOhio State UniversityPennsylvania State UniversityUniversity of PortsmouthPrinceton UniversitySpanish Participation GroupUniversity of TokyoUniversity of UtahVanderbilt UniversityUniversity of VirginiaUniversity of WashingtonYale UniversitySpanish Ministry of Economy and Competitiveness AYA-2011-27754McDonald Observator

Studi Volume Lalu Lintas di Jalan Raya Narogong Cileungsi, Kabupaten Bogor, Periode Agustus 2011

Survey of traffic volume is one of the simplest methods to obtain traffic data in order to better understand optimalisation andefficiency so that it can minimize vehicle traffic congestion problems on the highway. The method used is based on descriptive andanalytical methods, which is done is to classify the vehicles in classes manually by counting the number of vehicles per time unitbased on class - class. The purpose of the volume of traffic surveys carried out in the classified Narogong Cullinan Road, Bogorregency during the period August, 2011, results that can be found is the degree of saturation of the highway is still in an acceptablelevel. Analysis of traffic flow at the study site is still under the limit congestion. It is suggested that to reduce the traffic density, thetype of heavy vehicles such as out of the factory operates around the study site between the hours of 10:00 pm to 3:00 am

Vascular and blood-brain barrier-related changes underlie stress responses and resilience in female mice and depression in human tissue

Prevalence, symptoms, and treatment of depression suggest that major depressive disorders (MDD) present sex differences. Social stress-induced neurovascular pathology is associated with depressive symptoms in male mice; however, this association is unclear in females. Here, we report that chronic social and subchronic variable stress promotes blood-brain barrier (BBB) alterations in mood-related brain regions of female mice. Targeted disruption of the BBB in the female prefrontal cortex (PFC) induces anxiety- and depression-like behaviours. By comparing the endothelium cell-specific transcriptomic profiling of the mouse male and female PFC, we identify several pathways and genes involved in maladaptive stress responses and resilience to stress. Furthermore, we confirm that the BBB in the PFC of stressed female mice is leaky. Then, we identify circulating vascular biomarkers of chronic stress, such as soluble E-selectin. Similar changes in circulating soluble E-selectin, BBB gene expression and morphology can be found in blood serum and postmortem brain samples from women diagnosed with MDD. Altogether, we propose that BBB dysfunction plays an important role in modulating stress responses in female mice and possibly MDD

Experiments with Liquid Metal Walls: Status of the Lithium Tokamak Experiment

Liquid metal walls have been proposed to address the first wall challenge for fusion reactors. The Lithium Tokamak Experiment (LTX) at the Princeton Plasma Physics Laboratory (PPPL) is the first magnetic confinement device to have liquid metal plasma-facing components (PFC's) that encloses virtually the entire plasma. In the Current Drive Experiment-Upgrade (CDX-U), a predecessor to LTX at PPPL, the highest improvement in energy confinement ever observed in Ohmically-heated tokamak plasmas was achieved with a toroidal liquid lithium limiter. The LTX extends this liquid lithium PFC by using a conducting conformal shell that almost completely surrounds the plasma. By heating the shell, a lithium coating on the plasma-facing side can be kept liquefied. A consequence of the low-recycling conditions from liquid lithium walls is the need for efficient plasma fueling. For this purpose, a molecular cluster injector is being developed. Future plans include the installation of a neutral beam for core plasma fueling, and also ion temperature measurements using charge-exchange recombination spectroscopy. Low edge recycling is also predicted to reduce temperature gradients that drive drift wave turbulence. Gyrokinetic simulations are in progress to calculate fluctuation levels and transport for LTX plasmas, and new fluctuation diagnostics are under development to test these predictions. _________________________________________________

Determinants of countermovement jump performance: a kinetic and kinematic analysis

This is an Accepted Manuscript of an article published in Journal of Sports Sciences on 29 May 2014, available online: http://www.tandfonline.com/10.1080/02640414.2014.924055This study aimed to investigate the contributions of kinetic and kinematic parameters to inter-individual variation in countermovement jump (CMJ) performance. Two-dimensional kinematic data and ground reaction forces during a CMJ were recorded for 18 males of varying jumping experience. Ten kinetic and eight kinematic parameters were determined for each performance, describing peak lower-limb joint torques and powers, concentric knee extension rate of torque development and CMJ technique. Participants also completed a series of isometric knee extensions to measure the rate of torque development and peak torque. CMJ height ranged from 0.38 to 0.73 m (mean 0.55 ± 0.09 m). CMJ peak knee power, peak ankle power and take-off shoulder angle explained 74% of this observed variation. CMJ kinematic (58%) and CMJ kinetic (57%) parameters explained a much larger proportion of the jump height variation than the isometric parameters (18%), suggesting that coachable technique factors and the joint kinetics during the jump are important determinants of CMJ performance. Technique, specifically greater ankle plantar-flexion and shoulder flexion at take-off (together explaining 58% of the CMJ height variation), likely influences the extent to which maximal muscle capabilities can be utilised during the jump

miR-23b regulates cytoskeletal remodeling, motility and metastasis by directly targeting multiple transcripts

Uncontrolled cell proliferation and cytoskeletal remodeling are responsible for tumor development and ultimately metastasis. A number of studies have implicated microRNAs in the regulation of cancer cell invasion and migration. Here, we show that miR-23b regulates focal adhesion, cell spreading, cell-cell junctions and the formation of lamellipodia in breast cancer (BC), implicating a central role for it in cytoskeletal dynamics. Inhibition of miR-23b, using a specific sponge construct, leads to an increase of cell migration and metastatic spread in vivo, indicating it as a metastatic suppressor microRNA. Clinically, low miR-23b expression correlates with the development of metastases in BC patients. Mechanistically, miR-23b is able to directly inhibit a number of genes implicated in cytoskeletal remodeling in BC cells. Through intracellular signal transduction, growth factors activate the transcription factor AP-1, and we show that this in turn reduces miR-23b levels by direct binding to its promoter, releasing the pro-invasive genes from translational inhibition. In aggregate, miR-23b expression invokes a sophisticated interaction network that co-ordinates a wide range of cellular responses required to alter the cytoskeleton during cancer cell motility

Metabolomics: A Novel Approach to Early and Noninvasive Prostate Cancer Detection

Prostate cancer (PCa) is the most commonly diagnosed visceral cancer in men and is responsible for the second highest cancer-related male mortality rate in Western countries, with increasing rates being reported in Korea, Japan, and China. Considering the low sensitivity of prostate-specific antigen (PSA) testing, it is widely agreed that reliable, age-independent markers of the presence, nature, and progression of PCa are required to facilitate diagnosis and timely treatment. Metabolomics or metabonomics has recently emerged as a novel method of PCa detection owing to its ability to monitor changes in the metabolic signature, within biofluids or tissue, that reflect changes in phenotype and function. This review outlines the physiology of prostate tissue and prostatic fluid in health and in malignancy in relation to metabolomics as well as the principles underlying the methods of metabolomic quantification. Promising metabolites, metabolic profiles, and their correlation with the presence and stage of PCa are summarized. Application of metabolomics to biofluids and in vivo quantification as well as the direction of current research in supplementing and improving current methods of detection are discussed. The current debate in the urology literature on sarcosine as a potential biomarker for PCa is reviewed and discussed. Metabolomics promises to be a valuable tool in the early detection of PCa that may enable earlier treatment and improved clinical outcomes