Two-dimensional echocardiographic diagnosis of pulmonary artery sling in infancy

The vascular anomaly in which the left pulmonary artery arises from the right pulmonary artery and passes posteriorly and leftward between the trachea and the esophagus is termed a pulmonary artery sling. Two-dimensional echocardiograms were performed in five infants with this anomaly and successfully identified it in four, including one patient with truncus arteriosus communis.The subxiphoid long-axis sweep was useful in identifying the origin and initial course of the left pulmonary artery, and short-axis subxiphoid views showed both its origin from the right pulmonary artery and its initial posterior course. Angulation toward the cardiac apex displayed the right pulmonary artery in cross section anteriorly and the left pulmonary artery in cross section posteriorly. A transducer orientation midway between the subxiphoid long- and short-axis positions was helpful in distinguishing a large right upper lobe branch of the right pulmonary artery from a pulmonary artery sling. The precordial short-axis plane displayed the origin and initial posterior and leftward course of the left pulmonary artery, while the bifurcation of the main pulmonary artery, usually easily seen in this view, could not be demonstrated.Two-dimensional echocardiography offers a rapid, noninvasive diagnosis of pulmonary artery sling in infants

Double-inlet single left ventricle: Echocardiographic anatomy with emphasis on the morphology of the atrioventricular valves and ventricular septal defect

AbstractThe echocardiographic anatomy of double inlet single left ventricle was studied in 57 patients, aged 1 day to 27 years (mean 6 years); the variables examined included morphology, size and function of the atrioventricular AV) valves and ventricular septal defect and their relation to pulmonary stenosis, aortic stenosis and aortic arch obstruction. The visceroatrial situs was solitus and the heart was in the left side of the chest in all 57 patients. A d-loop ventricle was present in 21 patients and an l-loop ventricle in 36. The great arteries were normally related (Holmes heart) in 8 patients and transposed in 49.In all hearts, the right AV valve was anterior to the left AV valve. In 53 patients, the tricuspid valve (right valve in d-loop and left valve in l-loop) was closer to and had attachments on the septum. The tricuspid valve straddled the outflow chamber in eight patients. No significant difference was noted in the mean AV valve diameter when comparing mitral and tricuspid valves within the same group or between the groups with a d- or l-loop ventricle. The right AV valve diameter had a significant direct correlation with the aortic valve diameter and the size or (he ventricular septal defect regardless of ventricular loop. Both AV valves were functionally normal in 34 patients. Among patients with AV valve dysfunction, the tricuspid valve tended to be stenotic in patients with an l-loop ventricle and regurgitant in patients with a d-loop ventricle. Mitral valve dysfunction was uncommon.The ventricular septal defect (46 patients) was separated from the semilunar valves in 24 patients (muscular defect) and adjacent to the anterior semilunar valve as a result of hypoplasia or malalignment, or both, of the infundibular septum (subaortic defect) in 19 patients. Multiple defects were present in three patients. The difect was unrestrictive in 26 patients, restrictive in 23 and could not be evaluated in 8. Pulmonary artery banding had been performed in 8 of the 26 patients with an unrestrictive defect and in 10 of the 23 patients with a restrictive defect. Only 4 of 19 subaortic defects compared with 16 of 24 muscular defects were restrictive. The size of the defect was significantly correlated with the measured pressure gradient. Among patients with transposition, only 2 of 13 with pulmonary stenosis had a restrictive ventricular septal defect compared with 15 of 30 without pulmonary stenosis. In patients with transposition, the defect size was significantly smaller when coarctation was present

Universal continuous-variable quantum computation: Requirement of optical nonlinearity for photon counting

Although universal continuous-variable quantum computation cannot be achieved via linear optics (including squeezing), homodyne detection and feed-forward, inclusion of ideal photon counting measurements overcomes this obstacle. These measurements are sometimes described by arrays of beam splitters to distribute the photons across several modes. We show that such a scheme cannot be used to implement ideal photon counting and that such measurements necessarily involve nonlinear evolution. However, this requirement of nonlinearity can be moved "off-line," thereby permitting universal continuous-variable quantum computation with linear optics.Comment: 6 pages, no figures, replaced with published versio

Efficient Classical Simulation of Optical Quantum Circuits

We identify a broad class of physical processes in an optical quantum circuit that can be efficiently simulated on a classical computer: this class includes unitary transformations, amplification, noise, and measurements. This simulatability result places powerful constraints on the capability to realize exponential quantum speedups as well as on inducing an optical nonlinear transformation via linear optics, photodetection-based measurement and classical feedforward of measurement results, optimal cloning, and a wide range of other processes.Comment: 4 pages, published versio

Diffusion MRI Tractography of the Developing Human Fetal Heart

Objective: Human myocardium has a complex and anisotropic 3D fiber pattern. It remains unknown, however, when in fetal life this anisotropic pattern develops and whether the human heart is structurally fully mature at birth. We aimed here to use diffusion tensor MRI (DTI) tractography to characterize the evolution of fiber architecture in the developing human fetal heart. Methods: Human fetal hearts (n = 5) between 10–19 weeks of gestation were studied. The heart from a 6-day old neonate and an adult human heart served as controls. The degree of myocardial anisotropy was measured by calculating the fractional anisotropy (FA) index. In addition, fiber tracts were created by numerically integrating the primary eigenvector field in the heart into coherent streamlines. Results: At 10–14 weeks the fetal hearts were highly isotropic and few tracts could be resolved. Between 14–19 weeks the anisotropy seen in the adult heart began to develop. Coherent fiber tracts were well resolved by 19 weeks. The 19-week myocardium, however, remained weakly anisotropic with a low FA and no discernable sheet structure. Conclusions: The human fetal heart remains highly isotropic until 14–19 weeks, at which time cardiomyocytes self-align into coherent tracts. This process lags 2–3 months behind the onset of cardiac contraction, which may be a prerequisite for cardiomyocyte maturation and alignment. No evidence of a connective tissue scaffold guiding this process could be identified by DTI. Maturation of the heart’s sheet structure occurs late in gestation and evolves further after birth

Deep Chandra Observations of Abell 2199: the Interplay between Merger-Induced Gas Motions and Nuclear Outbursts in a Cool Core Cluster

We present new Chandra observations of Abell 2199 that show evidence of gas sloshing due to a minor merger, as well as impacts of the radio source, 3C 338, hosted by the central galaxy, NGC 6166, on the intracluster gas. The new data are consistent with previous evidence of a Mach 1.46 shock 100" from the cluster center, although there is still no convincing evidence for the expected temperature jump. Other interpretations of this feature are possible, but none is fully satisfactory. Large scale asymmetries, including enhanced X-ray emission 200" southwest of the cluster center and a plume of low entropy, enriched gas reaching 50" to the north of the center, are signatures of gas sloshing induced by core passage of a merging subcluster about 400 Myr ago. An association between the unusual radio ridge and low entropy gas are consistent with this feature being the remnant of a former radio jet that was swept away from the AGN by gas sloshing. A large discrepancy between the energy required to produce the 100" shock and the enthalpy of the outer radio lobes of 3C 338 suggests that the lobes were formed by a more recent, less powerful radio outburst. Lack of evidence for shocks in the central 10" indicates that the power of the jet now is some two orders of magnitude smaller than when the 100" shock was formed.Comment: 17 pages, 20 figures, accepted for publication in Ap

Symplectically-invariant soliton equations from non-stretching geometric curve flows

A moving frame formulation of geometric non-stretching flows of curves in the Riemannian symmetric spaces $Sp(n+1)/Sp(1)\times Sp(n)$ and $SU(2n)/Sp(n)$ is used to derive two bi-Hamiltonian hierarchies of symplectically-invariant soliton equations. As main results, multi-component versions of the sine-Gordon (SG) equation and the modified Korteweg-de Vries (mKdV) equation exhibiting $Sp(1)\times Sp(n-1)$ invariance are obtained along with their bi-Hamiltonian integrability structure consisting of a shared hierarchy of symmetries and conservation laws generated by a hereditary recursion operator. The corresponding geometric curve flows in $Sp(n+1)/Sp(1)\times Sp(n)$ and $SU(2n)/Sp(n)$ are shown to be described by a non-stretching wave map and a mKdV analog of a non-stretching Schr\"odinger map.Comment: 39 pages; remarks added on algebraic aspects of the moving frame used in the constructio

Congenital supravalvar mitral ring: An underestimated anomaly

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