Resolution of Dialyzer Membrane-Associated Thrombocytopenia with Use of Cellulose Triacetate Membrane: A Case Report

Blood and dialyzer membrane interaction can cause significant thrombocytopenia through the activation of complement system. The extent of this interaction determines the biocompatibility of the membrane. Although the newer synthetic membranes have been shown to have better biocompatibility profile than the cellulose-based membranes, little is known about the difference in biocompatibility between synthetic membrane and modified cellulose membrane. Herein, we report a case of a patient on hemodialysis who developed dialyzer-membrane-related thrombocytopenia with use of synthetic membrane (F200NR polysulfone). The diagnosis of dialyzer membrane-associated thrombocytopenia was suspected by the trend of platelet count before and after dialysis, and the absence of other possible causes of thrombocytopenia. We observed significant improvement in platelet count when the membrane was changed to modified cellulose membrane (cellulose triacetate). In patients at high risk for thrombocytopenia, the modified cellulose membrane could be a better alternative to the standard synthetic membranes during hemodialysis

Depositional architecture and processes of sediment gravity flows: a 3D seismic case study from offshore Angola

Deepwater environments are characterised by the deposits of mass flows (e.g. debrites, slumps, slides), sediment density flows (turbidites), and background hemipelagic and pelagic suspension fallout. ‘Mass transport’ is a general term used for the failure and downslope movement of sediment under the influence of gravity in both subaerial and subaqueous environments, the products of which are called Mass Transport Deposits (MTDs). The aims of this study are: (i) to investigate the temporal and spatial development of sediment gravity flows, particularly the coupling of MTDs, turbidites and hemipelagites (ii) to characterise and interpret the seismic facies present within a well-imaged deep-water succession, offshore Angola, with particular focus on the external morphology and distribution of MTDs and associated sediment gravity flows; (iii) to document the geometry, scale, distribution and kinematic importance of structures within the MTDs and relate these to the emplacement of these deposits, in order to understand the impact of seafloor bathymetry on the distribution of the deep-water deposits; and (iv) to characterise and classify the development of pockmarks that are formed contemporaneously or successive to the emplacement of the MTDs. Key results of this study are that: (1) the grade of the submarine slope is a primary intra-basinal control on the emplacement and depositional patterns of MTDs and associated sediment gravity flows, (2) the emplacement of MTDs in upper slope environments promotes the capturing and trapping of sediments, (3) strain indicators genetically linked to MTDs record kinematic information related to the initiation, translation and ultimate deposition of the MTDs, (4) pockmarks may develop from the dewatering of MTDs due to their rapid transportation and consequent entrapment of fluid, and (5) the distribution of pockmarks in slope sediments may be haphazard, but pockmarks may also form preferentially along fault traces and along the evacuation planes of MTDs.Open Acces

Management of Hypertension among Patients with Coronary Heart Disease

Evidence suggests that coronary heart disease (CHD) is the most common outcome of hypertension. Hypertension accelerates the development of atherosclerosis, and sustained elevation of blood pressure (BP) can destabilize vascular lesions and precipitate acute coronary events. Hypertension can cause myocardial ischemia in the absence of CHD. These cardiovascular risks attributed to hypertension can be reduced by optimal BP control. Although several antihypertensive agents exist, the choice of agent and the appropriate target BP for patients with CHD remain controversial. In this succinct paper, we examine the evidence and the mechanisms for the linkage between hypertension and CHD and we discuss the treatment options and the goals of therapy that are consistent with the report of the seventh Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) and American Heart Association scientific statement. We anticipate changes in the recommendations of the forthcoming JNC 8

Origin and anatomy of two different types of mass-transport complexes: a 3D seismic case study from the northern South China Sea margin

Integration of 2D and 3D seismic data from the Qiongdongnan Basin along the northwestern South China Sea margin has enabled the seismic stratigraphy, seismic geomorphology and emplacement mechanisms of eight separate, previously undocumented, mass-transport complexes (MTCs) to be characterized. These eight MTCs can be grouped into two types:. (1) Localized detached MTCs, which are confined to submarine canyons and cover hundreds of km, consist of a few tens of km remobilized sediments and show long striations at their base. They resulted from small-scale mass-wasting processes induced by regional tectonic events and gravitational instabilities on canyon margins.(2) Regional attached MTCs, which occur within semi-confined or unconfined settings and are distributed roughly perpendicular to the strike of the regional slope. Attached MTCs occupy hundreds to thousands of km and are composed of tens to hundreds of km of remobilized sediments. They contain headwall escarpments, translated blocks, remnant blocks, pressure ridges, and basal striations and cat-claw grooves. They were created by large-scale mass-wasting processes triggered by high sedimentation rates, slope oversteepening by shelf-edge deltas, and seismicity.Our results show that MTCs may act as both lateral and top seals for underlying hydrocarbon reservoirs and could create MTC-related stratigraphic traps that represent potential drilling targets on continental margins, helping to identify MTC-related hydrocarbon traps

Mass-Transport Complexes as Markers of Deep-Water Fold-and-Thrust Belt Evolution: Insights From the Southern Magdalena Fan, Offshore Colombia

Mass-wasting of tectonically active margins is an important process in the degradation of deep-water fold-and-thrust belts. However, tectono-stratigraphic links between mass-transport complexes (MTCs), the evolution of MTC basal surfaces, and the timing, and spatial progression of deformation have not been extensively studied. This study uses high-quality, 3D seismic reflection data from the southern Magdalena Fan, offshore Colombia to investigate how the growth of a deep-water fold-and-thrust belt (the southern Sinú Fold Belt) is reflected in the source, distribution and size of MTCs. At least 11 distinct, but now-coalesced MTCs, overlie this surface. Their size and source location changed through time: the oldest, ‘detached’ MTCs are relatively small (10-160 km2) and sourced from the flanks of growing anticlines; the younger, ‘shelf-attached’ MTCs are considerably larger (200-400 km2), are sourced from the shelf and post-date the main phase of active thrusting and folding. Changes in the source, distribution and size of MTCs are tied to the sequential nucleation, amplification and along-strike propagation of individual structures showing that MTCs can be used to constrain the timing and style of deformation, and seascape evolution in time and space. The basal surface of the largest MTC was created by multiple syn-tectonic and post-tectonic mass-wasting events, is highly diachronous and represents an extended period of slope instability. Thus, the geometry and extent of MTC basal surfaces can evolve through time, and the deposits that overlie them do not necessarily record the processes that led to their creation. These insights complicate assessments of the anatomy and genesis of MTC basal surfaces and could be applied at deeper burial depths where seismic resolution may be poor

Submarine channel network evolution above an extensive mass-transport complex: A 3D seismic case study from the Niger delta continental slope

A submarine channel network, named Abalama Channel System (ACS), has been recognised in the subsurface of the Niger Delta continental slope. It overlies a mass-transport complex (MTC) and consists of six channel segments, delimited by five avulsion points and one confluence point. High-resolution 3D seismic data are used to investigate the development of the ACS and to describe the interaction between the channels and the underlying MTC. The MTC mainly consists of highly disaggregated materials (MTC matrixes) and in plan-view has a very complex fingered geometry, characterised by the presence of erosional remnants (remnant blocks). The different character of the MTC matrixes compared to that of the remnant blocks likely resulted in a bathymetry characterised by negative and positive relief, which provided the initial confinement for the channels of the ACS. In areas where the MTC-induced confinement was weak or decreased abruptly, channels tended to develop higher sinuosity, increasing channels instability and ultimately causing avulsions. Three ideal categories of submarine channel avulsions are observed. Type 1 is characterised by parent and avulsion channel having similar size and maturity; Type 2 is characterised by a large, high-maturity parent channel and a small, low-maturity avulsion channel; Type 3 emphasizes the larger scale and higher maturity of the avulsion channel compared to the parent channel. In the distal part of the study area, topography related to mud diapirs provided lateral confinement that captured flows avulsed at different times resulting in a channel confluence phenomenon. Submarine channel network evolution recorded by avulsion and confluence points represents an important research theme in deep-water sedimentology, as it controls the final distribution of sediments and the extension of sands in the whole deep-water depositional system; hence this study can be used to guide hydrocarbon exploration in analogue systems

Depositional architecture of sand-attached and sand-detached channel-lobe transition zones on an exhumed stepped slope mapped over a 2500 km2 area

The geomorphology and seismic stratigraphy of deep-water clastic systems from slope valleys through channel-levee systems to basin-floor fans have been observed and described in modern and ancient sub surface examples around the world. However, the distribution of sedimentary facies, grain size, and small-scale architectural elements remains poorly constrained. Extensive exposures (>2500 km2) of four stacked deep-water composite sequences have been mapped from heterolithic channel-levee systems on the slope to sand-rich basin-floor deposits. The data set from Units C-F of the Fort Brown Formation in the Permian Laingsburg depocenter of South Africa permits a unique opportunity to document and compare their depositional architecture at a high resolution for tens of kilometers downdip. Isopach thickness maps indicate that compensational stacking across multiple stratigraphic scales occurs on the basin floor, whereas preferred axial pathways were present on the slope, leading to subvertical stacking patterns. Units C and D are sand-attached systems; slope valley systems are mapped to pass transitionally downslope through leveeconfined channels to lobe complexes over distances of >30 km. The slope valley fills of Units E and F, however, are separated from their downdip sand-rich lobe complexes by a thin, sand-poor tract several kilometers in length and are termed sand detached. Locally, this sand-poor tract is characterized by a distinctive facies association of thin-bedded turbidites with numerous scours mantled with rip-up clasts, and a top surface that includes megaflutes and remobilized sediments. This assemblage is interpreted to indicate a widespread area of sand bypass. This unique data set provides an exploration- scale insight and understanding of how different segments of a prograding slope evolved over time in terms of gradient, physiography, and hence the degree to which sand was stored or bypassed to the basin floor, and the evolution from sand-attached to sand-detached systems. The development of sand-detached systems suggests that a steeper gradient formed, possibly related to developing underlying structure, that led to the development of a stepped slope profile. The study highlights that updip stratigraphic trapping at reservoir scale can occur with minor bathymetric changes

Disconnected submarine lobes as a record of stepped slope evolution over multiple sea-level cycles

The effects of abrupt changes in slope angle and orientation on turbidity current behavior have been investigated in numerous physical and numerical experiments and examined in outcrop, subsurface, and modern systems. However, the long-term impact of subtle and evolving seabed topography on the stratigraphic architecture of deep-water systems requires fine-scale observations and extensive 3-D constraints. This study focuses on the Permian Laingsburg and Fort Brown formations, where multiple large sand-rich systems (Units A–F) have been mapped from entrenched slope valleys, through channel-levee systems, to basin-floor lobe complexes over a 2500 km2 area. Here, we investigate three thinner (typically <5 m in thickness) and less extensive sand-rich packages, Units A/B, B/C, and D/E, between the large-scale systems. Typically, these sand-rich units are sharp-based and topped, and contain scours and mudstone clast conglomerates that indicate deposition from high-energy turbidity currents. The mapped thickness and facies distribution suggest a lobate form. These distinctive units were deposited in similar spatial positions within the basin-fill and suggest similar accommodation patterns on the slope and basin floor prior to the larger systems (B, C, and E). Stratigraphically, these thin units represent the first sand deposition following ­major periods of shut-down in sediment supply, and are interpreted as marking a partial re-establishment of sand delivery pathways creating “disconnected lobes” that are fed mainly by flows sourced from failures on the shelf and upper slope rather than major feeder channel-levee systems. Thickness and facies patterns throughout the deep-water stratigraphy suggest seabed topography was present early in the basin formation and maintained persistently in a similar area to ultimately form a stepped slope profile. The stepped slope profile evolved through three key stages of development: Phase 1, where sediment supply exceeds deformation rate (likely caused by differential subsidence); Phase 2, where sediment supply is on average equal to deformation rate; and Phase 3, where deformation rate outpaces sediment supply. This study demonstrates that smaller systems are a sensitive record of evolving seabed topography and they can consequently be used to recreate more accurate paleotopographic profiles

The role of tectonics and mass-transport complex emplacement on upper slope stratigraphic evolution: A 3D seismic case study from offshore Angola

Three dimensional seismic-reflection data of the mid-Pliocene-to-Holocene upper slope succession, offshore Angola, provide an opportunity to constrain the stratigraphic context, distribution, external morphology and internal strain within mass-transport deposits (MTDs). These data also allow an assessment of the impact that erosion and relief associated with MTDs have on upper slope stratigraphy and depositional patterns, and the role that MTDs play in achieving 'grade' on submarine slopes. The study area is dissected by a series of NW-SE-striking, thin-skinned, salt-detached normal faults, which bound a slope-perpendicular, intra-slope horst that divides the study area into two depocentres. Three main seismic packages and their six constituent units have been mapped across the study area and reveal that, during the initial stages of deposition, a series of MTDs were emplaced, the thickness and distribution of which are controlled by the intra-slope horst. Substantial volumes of substrate were removed and entrained into the parent flow, and significant and irregular relief (150 m) was developed along MTDs upper surface. This MTD-richpackage is interpreted to document a time when the slope was above grade, degradational processes dominated and sediment was trapped on the upper slope due to tectonic accommodation. Subsequent deposition was from either turbidity currents or and suspension fallout, at a time when the slope had begun to achieve 'grade' and depositional processes dominated. The associated depositional units display only minimal thickness variations with respect to the intra-slope horst, which had been 'healed' by this time; however, the unit displays pronounced and abrupt changes in thickness due to infilling of relief at the top of the preceding MTDs. The uppermost strata document a time when the slope was at grade and constructional process (i.e. aggradation and progradation) dominated. Deposition at this time was characterised by progradation of a mudstone-dominated, gullied slope system. This study highlights the role that tectonically- and mass transport-driven changes in bathymetry can have on upper slope accommodation and sediment dispersal. From a hydrocarbon exploration perspective this is critical, because tectonic and depositional accommodation provide a mechanism for capturing and trapping clastic sediments in an upper slope setting, which is otherwise typically associated with coarse-grained sediment bypass