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Segmental arterial mediolysis, reparative phase: An analysis and case report showing conversion to fibromuscular dysplasia with renal infarction

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World Journal of Cardiovascular Diseases 2014年第2期4卷 50-60页

作者： Richard E. Slavin julian del cerro gonzalez Jose Manuel Machin Angel Robles Rita Maria Regojo Marie Luisa Diez Department of Internal Medicine La Paz University Hospital Madrid Spain Department of Internal Medicine University Hospital Guadalajara Spain Department of Pathology Legacy Emanuel Hospital Portland Oregon USA Department of Pathology University Hospital Guadalajara Spain Family Practice Physician Guadalajara Health Center Cervantes Branch Guadalajara Spain Interventional Radiologist University Hospital Guadalajara Spain

Segmental arterial mediolysis (SAM), an uncommon arteriopathy putatively caused by norepinephrine released by alpha-1 adrenergic agonists or some Beta-2 agonists capable of releasing norepinephrine from the peripheral sympathetic nervous system potentially can present ischemic and organ injury symptoms caused by sequelae created in its reparative phase in lieu of catastrophic hemorrhages announced in its injurious phase. The case documents this presentation—the patient presenting renal infarcts and ischemic lesions causing abdominal angina, hypertension and a nephrectomy event developing 10 years after prolonged ritodrine treatment for premature labor. This agent may have directly caused SAM or sensitized the patient to agonists causing SAM encountered at a latter date. A variety of lesions derived from injurious phase arterial injuries characterize reparative phase SAM. All were encountered in a hilar branch of the resected renal artery. These included side-by-side sequela aneurysms grossly forming a large fusiform aneurysm, granulation tissue filling adventitial medial tear spaces in which a dissecting hematomas developed, medial muscle loss centered to the outer media repaired with fibrous tissue, arterial stenosis created by reparative intimal plaques, and arterial thrombo-embolism. These lesions were mirrored in accompanying radiologic studies. The accompanying renal vein exhibited changes consistent with repair of the spastic venous angiopathy that often accompanies abdominal SAM. This angiopathy, putatively induced by Endothelin-1, suggested that this agent played a role in the genesis of the arterial lesions. Angiographic resolution of non-treated sequelae occurred in 5 months either spontaneously or due to treatment with bosentem. Conclusions: The histologic and angiographic changes demonstrate that the clinical onset of reparative SAM may be significantly delayed to produce ischemic lesions, renal infarction and in this case report, medial fibromuscular dy

关键词： Segmental Arterial Mediolysis Fibromuscular Dysplasia Ritodrine Renal Infarcts Dissecting Hematoma Intestinal Angina Endothelin-1 Bosentem

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Modelling the daily reference evapotranspiration in semi-arid region of South India: A case study comparing ANFIS and empirical models

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Information Processing in Agriculture 2021年第1期8卷 173-184页

作者： Ramiro T.gonzalez del cerro M.S.P Subathra Nallapaneni Manoj Kumar Sebastian Verrastro S.Thomas George Departamento de Ingenieria Electronica Facultad Regional Buenos AiresUniversidad Tecnologica NacionalBuenos AiresArgentina Department of Electrical Sciences Karunya Institute of Technology and SciencesCoimbatore 641114Tamil NaduIndia School of Energy and Environment City University of Hong KongKowloonHong KongChina Sustainable Solutionz T NagarChennai-600017Tamil NaduIndia

The estimation of evapotranspiration(ETo)is one of the main tools for the control of crop growth and to make a rational use of water *** estimate this parameter accurately,it is necessary to have a daily measurement of four meteorological variables,these are:temperature,solar radiation,relative humidity and wind *** is not always possible to count on all the variables,that is why there are empirical methods that use a limited number of variables that make an approximate estimate of the ETo *** of these models are applicable to different regions with completely different *** this paper,a study has been carried out to define the model of ETo estimation that best adapts to the semi-arid region in South *** different datasets for the same period from different meteorological stations were *** addition to the empirical methods for estimating ETo,computer models ANFIS(Adaptive Neuro-Fuzzy Inference System)were *** models consist in the future estimation of a certain parameter by using current variables and a history of variables and past *** results of this work show that ANFIS 11 model makes the best estimate with RMSD=0.002 and r=*** RITCHIE method is the most suitable empirical model for this region,which reaches RMSD=0.507 and r=*** addition,ranking of equations is elaborated for both datasets for daily estimates of ***,comparison is made with the results for each case and thus confirm or reject the convenience of one model over the *** achieve this,a series of statistical indicators were used:Index of agreement(d),MAE(Mean absolute error),SEE(Standard error of estimate)and RMSD(Root mean square difference).Moreover,a sensitivity analysis was performed in order to compare and show the stability of the best models when an error is introduced within the input *** this case,the empirical models demonstrate a better performance than the ANFIS *** work demonstrates that th

关键词： Evapotranspiration ANFIS ANN Semi-arid regions in India Coimbatore RITCHIE method

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